Osinowo Adedapo Olumide, Olajide Thomas Olagboyega, Balogun Olanrewaju Samuel, Makanjuola Ayomide, Adesanya Adedoyin Adekunle, Atoyebi Oluwole A
Department of Surgery, General Surgery Unit, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Department of Surgery, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
J West Afr Coll Surg. 2023 Jan-Mar;13(1):67-73. doi: 10.4103/jwas.jwas_219_22. Epub 2023 Jan 18.
Gastric cancer (GC) is an important cause of morbidity and mortality in Nigeria. Significant advances in the management of GC in South-West Nigeria occurred in the last three decades.
This was a retrospective comparative study of patients with GC that presented at our tertiary hospital in the last three decades. Information on clinicopathological features and treatment outcome were analysed. Data of two consecutive periods; 1991-2004 (Group I) and 2005-2018 (Group II) were compared.
Ninety-one patients were studied; Group I (47 patients), Group II (44 patients). The mean age was 56.4 ± 12.7 years and male-to-female ratio was 1.8 to 1.0. The predominant symptoms were epigastric pain in 81(89.0%) (43 vs. 38) and weight loss in 63(69.2%) (32 vs. 31), whereas the signs were epigastric tenderness in 44(46.1%) (24 vs. 20) and epigastric mass in 42(46.1%) (26 vs. 16). The overall mean duration of symptom was 12.3 ± 16.9 months. Barium meal diagnosed GC in 29(61.7%) patients in Group I vs. 4(9.1%) patients in Group II. Conversely, endoscopy diagnosed GC in 23(48.9%) patients in Group I vs. 37(84.1%) patients in Group II. Operations undertaken included palliative subtotal gastrectomy 26(28.6%), potentially curative subtotal gastrectomy 15(16.5%) and non-resectional surgeries in 27(29.7%) patients. The overall incidence of major post-operative complications was 33%. Thirty-nine (42.8%) of the studied patients were lost to follow up. The median postoperative survival for Groups I and II patients was 22 weeks and 58 weeks, P = 0.012, respectively.
The outcome of management of patients with GC at our tertiary hospital has improved modestly in the past three decades. Patients are still presenting late with very advanced disease.
胃癌（GC）是尼日利亚发病和死亡的重要原因。在过去三十年中，尼日利亚西南部的胃癌管理取得了重大进展。
这是一项对过去三十年在我们三级医院就诊的胃癌患者进行的回顾性比较研究。分析了临床病理特征和治疗结果的信息。比较了两个连续时期的数据：1991 - 2004年（第一组）和2005 - 2018年（第二组）。
共研究了91例患者；第一组（47例），第二组（44例）。平均年龄为56.4±12.7岁，男女比例为1.8比1.0。主要症状为上腹部疼痛81例（89.0%）（43例对38例）和体重减轻63例（69.2%）（32例对31例），体征为上腹部压痛44例（46.1%）（24例对20例）和上腹部肿块42例（46.1%）（26例对16例）。症状的总体平均持续时间为12.3±16.9个月。第一组29例（61.7%）患者通过钡餐诊断为胃癌，而第二组为4例（9.1%）。相反，第一组23例（48.9%）患者通过内镜诊断为胃癌，而第二组为37例（84.1%）。进行的手术包括姑息性胃大部切除术26例（28.6%）、潜在根治性胃大部切除术15例（16.5%）和非切除性手术27例（29.7%）。术后主要并发症的总体发生率为33%。39例（42.8%）研究患者失访。第一组和第二组患者的术后中位生存期分别为22周和58周，P = 0.012。
在过去三十年中，我们三级医院胃癌患者的管理结果有适度改善。患者仍就诊较晚，疾病已非常晚期。
