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Impact of delayed care on surgical management of patients with gastric cancer in a low-resource setting.
Impact of delayed care on surgical management of patients with gastric cancer in a low-resource setting.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2018 Dec; Vol. 118 (8), pp. 1237-1242. Date of Electronic Publication: 2018 Oct 31. - Publication Year :
- 2018
-
Abstract
- Background: Gastric cancer is the fifth most common cancer in Eastern Africa. Diagnostic delays in low-resource countries result in advanced disease presentation. We describe perioperative management of gastric cancer in Rwanda.<br />Methods: A retrospective review of records at three hospitals was performed to identify gastric adenocarcinoma cases from January 2012 to June 2016. Multiple perioperative and tumor-related variables were collected. Descriptive and bivariate analyses were performed.<br />Results: The final analysis included 229 patients with gastric cancer. Median age was 58 years (interquartile range [IQR] 49-65) and 49.6% were female (n = 114). Patients reported symptoms (ie, weight loss, epigastric pain) for a median time of 12 months (IQR 7.5-24). On presentation, 18.8% ( n = 43) had gastric outlet obstruction; 13.5% ( n = 31) had a palpable mass. Fifty-one percent ( n = 117) underwent an operation; of these, 74% ( n = 86) received gastrojejunostomy or were inoperable; and 29% ( n = 34) underwent curative resection. Palliative care referrals were made for 9% ( n = 20). Pathology reports were available for 190 patients (83.0%). Only 11.3% ( n = 26) had Helicobacter pylori ( H. pylori) testing of which 65.4% tested positive ( n = 17).<br />Conclusions: A majority of patients presented with advanced disease. Very few patients had a curative resection. Significant advances in diagnosis and treatment are needed to improve the care of gastric cancer patients in Rwanda.<br /> (© 2018 Wiley Periodicals, Inc.)
- Subjects :
- Adenocarcinoma economics
Adenocarcinoma microbiology
Adenocarcinoma pathology
Adenocarcinoma surgery
Cohort Studies
Digestive System Surgical Procedures economics
Digestive System Surgical Procedures methods
Female
Helicobacter Infections microbiology
Helicobacter Infections pathology
Helicobacter pylori isolation & purification
Humans
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
Rwanda
Stomach Neoplasms economics
Stomach Neoplasms microbiology
Stomach Neoplasms pathology
Time-to-Treatment
Treatment Outcome
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 118
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30380140
- Full Text :
- https://doi.org/10.1002/jso.25286