Gastric Adenocarcinoma: Epidemiology, Diagnosis and Treatment at Joliot Curie Cancer Institute: About 136 Patients

Objectives: To report the epidemiological, diagnostic and therapeutic aspects of gastric adenocarcinoma at the Joliot Curie Cancer Institute. Results: There were about 136 cases of gastric adenocarcinoma over a 13-year period. The sex ratio was 1.125. The mean age was 54.29 years. The main risk factors found were epigastric pain, (9.6%), a history of gastric cancer surgery, (1.5%), and smoking (15.4%). Epigastric pain was the most frequent symptom, (65.4%), followed by vomiting. Patients were classified WHO 2 and 3 for 61.8% of the cases according to their clinical status. An epigastric mass was found in 44 patients, (32.4%), and ascites in 8 patients, (5.9%). Hepatomegaly and a sus clavicular node were found in 7% of the cases. Anemia was found in 59 patients, (43.3%), and hemoglobin was less than 8 in 16 patients, (11.7%). Localization was mostly antro pyloric (59.6%) and ulcerous-budding cancer dominated the macroscopic aspects (40.41%). The disease was at stage I in 2.4% of the cases, at stage II in 15.6% of the cases, at stage III in 4% of the cases, and at stage IV in 78% of the cases. Histo pathology showed tubulous or intestinal adenocarcinoma in more than 61% of the patients. Curative surgery was performed in 31 patients (22.8%) and palliative surgery in 39 patients (28.7%). Chemotherapy was given to 53 patients (39%), including 46 cases of palliative chemotherapy (33.8%). After a mean follow-up time of six months, there was a local-regional recurrence in 2 patients, metachronous metastasis in 66 patients (48.5% of the cases); death occurs in 23 patients (16.9% off the cases). Conclusion: Gastric adenocarcinoma in West Africa is a heterogenous histopathologic disease dominated by intestinal and tubular subtypes. It is diagnosed at an advanced stage. Its prognosis is very poor. Routine endoscopy and neo adjuvant chemo radiotherapy should be developed.