J Med Assoc Thai 2020; 103 (6):577-84

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The Multi-Disciplinary Management of Gastric Adenocarcinoma: The Retrospective Analysis of Outcomes of Patients Treated at Vajira Hospital
Bandidwattanawong C Mail, Kantrakornkiti P

Background: Gastric adenocarcinoma is an uncommon gastrointestinal cancer in Thailand. The pathological features, pattern of relapses, treatments, and outcomes have not been explored systemically.

Objective: The primary outcome was to determine overall survival (OS) of patients. The secondary outcomes were to explore pathological features, pattern of relapses, outcomes of adjuvant and palliative treatments, and prognostic factors of survival.

Materials and Methods: The investigators conducted a retrospective analysis of patients with gastric cancer diagnosed between January 1, 2010 and December 31, 2015 and received medical attention at Vajira Hospital. Demographic data including gender, age, health schemes, histologic types, staging, surgical methods, paradigms of adjuvant treatment, metastatic sites, and chemotherapy regimens.

Results: There were 90 gastric cancer patients with adequate clinical data. The median age was 60 years (IQR 50 to 69). Most of them had infiltrative (poorly differentiated or signet-ring cell) histology (67, 74.4%) and presented with metastatic disease (42, 46.7%). The median OS of patients with stage 1/2, 3, and 4 were 85 months (IQR 19 to NR), 25 months (IQR 13 to 43), and 5 months (IQR 2 to 15), respectively. The investigators did not find the OS difference between patients receiving adjuvant chemoradiation compared to adjuvant chemotherapy. Among patients with non-metastatic diseases, patients who underwent total gastrectomy and patients with T3 to T4 were the independent factors of poor disease-free survival. Peritoneal carcinomatosis was the most common site of metastasis.

Conclusion: The outcomes of patients with gastric cancer in Thailand was poor due to the advanced stage at presentation. Compared to other parts of the world, gastric cancer in Thailand has many different features.

Keywords: Gastric cancer, Survival, Multi-disciplinary treatment, Thailand

DOI: doi.org/10.35755/jmedassocthai.2020.06.11093

Received 20 Feb 2020 | Revised 6 Apr 2020 | Accepted 7 Apr 2020

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