Current Status of Gastric Cancer in Thai Patients
DUANGPORN THONG-NGAM, M.D.*, PISIT TANGKIJVANICH, M.D.**,
VAROCHA MAHACHAI,M.D.***, PINIT KULLAVANIJAYA,M.D.***
Affiliation : * Division of Gastroenterology, Department of Physiology,
** Department of Biochemistry
*** Gastroenterology Unit, Department of Medicine, King Chuialongkorn Memorial Hospital, Bangkok 10330,
Thailand.
AbstractTo determine the current status in various aspects of gastric cancer in Thai patients,
we retrospectively reviewed the records of 119 patients with histologically proven gastric
cancer in King Chulalongkorn Memorial Hospital during the five-year period from 1994 to
1998. There were 72 males (60.5%) and 47 females (39.5%) with ages ranging from 22 to 91
years (mean age 60.2±15.1 years). Among these, 20 patients (16.8%) were younger than 40
years. The duration of symptoms prior to first presentation averaged 20 weeks and dyspepsia
and weight loss were the most common complaints. Lesion location was lower third in 40.3
per cent, middle third in 31.9 per cent, upper third in 15 .I per cent and entire stomach in 3.4
per cent of patients. Adenocarcinoma was the most common histological finding (91.6% ),
followed by lymphoma and leiomyosarcoma (3.4% each). Helicobacter pylori infection was
detected in 17 of 25 (68% ). The TMN staging was as follows: stage II, 5.9 per cent; stage III,
9.2 per cent; and stage IV, 68.9 per cent. (the stage was unknown in I6o/c). The overall !-year,
2-year and 5-year survival rates were 51.6 per cent, 17.5 per cent and 4.4 per cent, respec
tively. Management was surgical treatment in 58.9 per cent (total gastrectomy 14.5%, subtotal
gastrectomy 33.3% and palliative bypass surgery in 1 I. I%). Systemic chemotherapy was
the primary modality of therapy in 16.8 per cent and was adjuvant therapy in 18.5 per cent.
The median survival time of resectable cases was 1.00±0.53 years, significantly longer than
that of unresectable cases (0.11±0.03 years) (p=0.0025). However, the administration of
chemotherapy did not improve the survival rate. It is concluded that, in Thailand, gastric
cancer continues to be an important health problem and is generally associated with a poor
prognosis.
Keywords : Gastric Cancer, Thai Patients
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