Behavior of gastric cancer in Brazilian population

Abstract

BACKGROUND: Gastric cancer (GC) is a predominately male disease. Usually for every female that suffers from this condition there are two males and occurred an increase in the number of females in last decades. Brazil is poor in data about this issue. AIM: To verify if in Brazil it happened: a) a change in the gender ratio and on the average age of the patients; b) an increase in the number of patients with 70 years of age or more suffering from this disease; c) changes in the gender ratio and in the average age in the several gastric locations during the period of study. METHODS: The medical history of patients diagnosed with primary gastric adenocarcinoma, between 1971 and 1998 were obtained at Hospital das Clínicas of the University of São Paulo, São Paulo, SP, Brazil. Exclusion criteria were: patients suffering from a non epithelial gastric malignancy; adenocarcinoma from the intestinal metaplasia in the distal esophagus invading the proximal stomach and patients submitted to a gastric resection, due to a benign or malignant tumor during the last five years prior to the surgical procedure analyzed in this study. The patients were divided into 10 years age groups and also divided in three groups, according to their ages and time intervals. Interrelationships between gender and age, and with tumor´s location on gastric wall were analyzed. RESULTS: From 1971 to 1998, 1578 patients with GC were hospitalized. Among them, 1021 were treated with gastric resection, corresponding to 64.7% of all patients. There was an increase in the proportion of patients older than 70 years, and decrease between 41 and 70 years. There was no statistical significant difference among the average ages and the different locations. There were significant differences for the locations favoring proximal third and stump, both more prevalent in males. CONCLUSIONS: a) Occurred modifications in the ratio between genders: greater number of women and an increase in the number of male patients in the age group between 41 and 70 years; b) it was proved the greater number of occurrences in patients over 70 years of age; c) there was a greater increase in the male predominance in the tumors located in the stomach´s proximal third.

Complicações pós-operatórias após gastrectomia total no câncer gástrico: análise de 300 doentes

“…In Brazil, there are no exact statistics data of its actual incidence, but it certainly is among the countries with highest one. It is the most common malignancy that affects the digestive tract, and in some regions is considered the most affecting males, competing with lung cancer 10 . Surgical treatment is most appropriate, contributing to increase considerably the survival of their bearers.…”

Roux-en-Y gastroenteroanastomosis in the treatment of stenosing and advanced gastric adenocarcinoma

“…About 50% of all cases do not permit a curative procedure and a palliative surgery is necessary method to improve life quality 1,6,7 . There are many options of palliative treatment in advanced gastric cancer: gastrostomy, jejunostomy, total gastrectomy or sub-total gastrectomy with only tumour resection and bypass 4,6 .…”

“…D'Amato et al 7 comparing the three The advantages of Roux-en-Y reconstruction after a distal gastrectomy include a reduction of reflux gastritis and esophagitis, a decreased probability of gastric cancer recurrence, and a reduction in the incidence of surgical complications. The disadvantages of Roux-en-Y reconstruction include the possible development of stomal ulcer, an increased probability of cholelithiasis, increased difficulty with an endoscopic approach to the Vater´s ampulla, and the possibility of Roux stasis syndrome 8,9,10,11 .…”

“…The classic operation employed when the lesion is located in the lower part of the stomach is a latero-lateral gastroenteroanastomosis (Figure 1), that facilitates the gastric emptying, but frequently causes reflux of enteric contents into the stomach and the patients complains of epigastric pain and burnings. To avoid these symptoms another option is a Roux-en-Y latero-lateral gastroenteroanastomosis 4,6,7 .…”

Gastric cancer trends in epidemiology

“…Over the last 2 decades, an evolutionary approach to the introduction of early diagnosis strategies, surveillance programs, different types of surgery, and adjuvant treatments has been adopted (1,5) . Gastric cancer has a multifactorial etiology.…”