Epidemiology of Gastric Carcinoma and the Role of Palliative Resection in Cases with Peritoneal Metastasis at a Tertiary care centre in South India

Abstract

INTRODUCTION: Cancer is a major health problem in many countries including India. Since Cancer Registries are incomplete in India, only a few epidemiological studies have been done so far. The objective was to determine to examine the various factors influencing the incidence of gastric carcinoma
Stomach cancer remains a major cause of cancer-related deaths worldwide, with a low 5-year survival rate (<30%) due to late diagnosis. Adenocarcinoma, the most common type, is linked to Helicobacter pylori infection. Though India has a relatively low incidence, urbanization and dietary shifts are contributing to its rise. Early detection in Japan has improved survival rates, unlike most regions. Surgical removal is the only effective treatment, but recurrence remains a challenge. Efforts are ongoing to develop adjuvant therapies for better outcomes.
AIM: To study the epidemiology of various cases of carcinoma stomach and the role of palliative resection in cases presenting with peritoneal metastasis.
OBJECTIVES:
1. To study the prevalence of carcinoma stomach in Karpaga vinayaga institute of medical sciences.To assess the etiology, risk factors carcinoma stomach, histopathological types in relation to site of growth and age.
Materials and methods:
It is a hospital based prospective observational study conducted in the Karpaga vinayaga institute of medical sciencesUsing statistical table, a sample size of 70 was calculated and patients were recruited as per inclusion criteria. After informed consent, detailed clinical examination relevant investigations such as CBC, RFT, LFT, serum electrolytes, ultrasonography of abdomen and pelvis, plain CT/ CECT of abdomen and pelvis are performed for each participant.
MATERIALS AND METHODS
STUDY DESIGN–A PROSPECTIVE OBSERVATIONAL STUDY
STUDY AREA–Karpaga vinayaga institute of medical sciences.
STUDY POPULATION– Adult patients with clinical features of carcinoma stomach confirmed by computed tomography and endoscopy guided biopsy.
SAMPLE SIZE – 70 [4pq/d*d]
STUDY PERIOD – 2years [December 2019 - December 2021]
INCLUSION CRITERIA:
1. Patient aged above 18 years with complaints and investigations suggestive of carcinoma stomach.
2. Both operable and inoperable casesEXCLUSION CRITERIA:
• Carcinoma stomach patients not willing for the study.
METHODOLOGY: After obtaining informed written consent, clinical history, detailed clinical examination relevant investigations such as CBC, RFT, LFT, serum electrolytes, ultrasonography of abdomen and pelvis, plain CT/ CECT of abdomen and pelvis were done. After confirming the diagnosis, evaluating the nature of the disease and considering patient general condition, mode of treatment were planned including both surgical and non-surgical measures.
All the epidemiological and demographic data, clinical presentation, radiological, histopathological (preoperative and post operative) findings, inraoperative staging inoperable cases, findings in inoperable cases, need for preoperative and postoperative chemotherapy, different modalities of surgeries, management of cases with peritoneal metastasis were tabulated. Post operative followup was done and all events were tabulated. Statistical analysis of all collected data was done and conclusions were arrived for each of the classical findings and events.
Results: On a total of 70 participants, 30 percent were between the ages of 55 and 64, 24.29 percent were between the ages of 55 and 64, and 21.43 percent were between the ages of 65 and 75. Males made up 67.14 percent of the study population, while females made up 32.86 percent. In terms of occupation, 62.86 percent of participants were unemployed, while 37.14 percent were Coolie workers. On a total of 70 participants, 55.71 percent are middle-class and 44.29 percent are low-income. Our study revealed that Spicy foods, soda, tobacco and alcohol as risk factors for gastric cancer.
Conclusion: More research is needed to understand the aetiology, develop appropriate screening tests, identify high-risk populations, and develop and assess the effectiveness of primary prevention programmes.