ORIGINAL ARTICLES

Clinicopathological features and treatment outcome of patients with gastric cancer in Lagos: Is the outlook getting better?

Adedapo Olumide Osinowo¹, Thomas Olagboyega Olajide², Olanrewaju Samuel Balogun², Ayomide Makanjuola³, Adedoyin Adekunle Adesanya¹, Oluwole A Atoyebi¹

¹ Department of Surgery, General Surgery Unit, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
² Department of Surgery, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
³ Department of Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria

Correspondence Address:
Dr. Kelechi U Imediegwu
Adedapo Olumide Osinowo
Department of Surgery, General Surgery Unit, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Surulere, Lagos Nigeria

Source of Support: None
Conflict of Interest: None

Background: Gastric cancer (GC) is an important cause of morbidity and mortality in Nigeria. Significant advances in the management of GC in South-West Nigeria occurred in the last three decades.

Patients and Methods: This was a retrospective comparative study of patients with GC that presented at our tertiary hospital in the last three decades. Information on clinicopathological features and treatment outcome were analysed. Data of two consecutive periods; 1991–2004 (Group I) and 2005–2018 (Group II) were compared.

Results: Ninety-one patients were studied; Group I (47 patients), Group II (44 patients). The mean age was 56.4 ± 12.7 years and male-to-female ratio was 1.8 to 1.0. The predominant symptoms were epigastric pain in 81(89.0%) (43 vs. 38) and weight loss in 63(69.2%) (32 vs. 31), whereas the signs were epigastric tenderness in 44(46.1%) (24 vs. 20) and epigastric mass in 42(46.1%) (26 vs. 16). The overall mean duration of symptom was 12.3 ± 16.9 months. Barium meal diagnosed GC in 29(61.7%) patients in Group I vs. 4(9.1%) patients in Group II. Conversely, endoscopy diagnosed GC in 23(48.9%) patients in Group I vs. 37(84.1%) patients in Group II. Operations undertaken included palliative subtotal gastrectomy 26(28.6%), potentially curative subtotal gastrectomy 15(16.5%) and non-resectional surgeries in 27(29.7%) patients. The overall incidence of major post-operative complications was 33%. Thirty-nine (42.8%) of the studied patients were lost to follow up. The median postoperative survival for Groups I and II patients was 22 weeks and 58 weeks, P = 0.012, respectively.

Conclusion: The outcome of management of patients with GC at our tertiary hospital has improved modestly in the past three decades. Patients are still presenting late with very advanced disease.