Incidence of gastric carcinoma at King Faisal Specialist Hospital- Jeddah Saudi Arabia: a hospital-based study

Abstract

Stomach cancer is the fifth most common cancer worldwide, and the third leading cause of death from cancer making up 7% of cases and 9% of deaths. The present study aimed at providing an image of the incidence of gastric carcinoma, with all its epidemiological and pathological characteristics including their trends during the last decade in a tertiary care hospital in the western region of Saudi Arabia. After obtaining an Institutional Review Board approval to conduct this retrospective study in King Faisal Specialist Hospital, a tertiary care institution in the western part of Saudi Arabia; the charts of 76 consecutive patients diagnosed with gastric cancer between January 2002 and 2013, were abstracted. Forty seven patients were included in the study. The charts were reviewed for demographic data, clinical data, diagnostic tools, endoscopic location of the tumour, size of the tumour, the imaging performed, the pathological features, the treatment given, and the final outcome. Forty seven patients were included in the study, thirty three (70%) of them were males, and the mean age of all patients was 57.55 ± 19.24 years. Forty three of the patients (91.5%) had intestinal type, thirty two (68.1%) had poorly differentiated cancer. Fourteen out of the 47 had palliative chemotherapy and twenty two patients out of 47 underwent surgery with curative intent. Two out of the 22 who had surgery received neoadjuvant chemotherapy, while only 7 had adjuvant chemotherapy. Fifteen out of the 22 who underwent surgery died, seven out of the 22 had a recurrence. Median overall survival for the 47 patients was 7 months, and the overall survival for the 22 patients who underwent surgery was 24 months. The median overall survival for the 25 patients, who did not undergo surgery was 2 months (Log rank, p-value=0.0005). Gastric cancer is among the deadliest forms of cancer in Saudi Arabia, with gradual increase in the incidence over the last decade, but its incidence still considered low in comparison to other countries worldwide. The outcome of our patients was poor, and we believe this is due to late presentation in the majority of our patients. Surgery is the mainstay of treatment for resectable gastric cancer, while perioperative and adjuvant chemotherapy, as well as chemoradiation, can improve outcome of resectable gastric cancer with extended lymph node dissection. Further research is required to study the epidemiology and the pathological features and the mode of presentation of gastric cancer in the Kingdom of Saudi Arabia.