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Vol. 43. Issue 9.
Pages 506-514 (November 2020)
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Vol. 43. Issue 9.
Pages 506-514 (November 2020)
Original article
Frequency and clinical characteristics of early gastric cancer in comparison to advanced gastric cancer in a health area of Spain
Frecuencia y aspectos clínicos del cáncer gástrico precoz en relación con el avanzado en un área sanitaria de España
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Pedro Delgado-Guillenaa,b,
Corresponding author
pgdg20@gmail.com

Corresponding author.
, Víctor Morales-Alvaradoa, Consuelo Ramírez Salazara, Mireya Jimeno Ramiroc, Gemma Llibre Nietoa, Jose Galvez-Olorteguid,e, Hugo Uchimaf
a Unidad de Aparato Digestivo, Hospital General de Granollers, Barcelona, Spain
b Universitat de Barcelona, Barcelona, Spain
c Unidad de Anatomía Patológica, Hospital General de Granollers, Barcelona, Spain
d Unidad Generadora de Evidencias y Vigilancia Epidemiológica, Scientia Clinical and Epidemiological Research Institute, Trujillo, Peru
e Vicerrectorado de Investigación, Universidad Nacional Santiago Antúnez de Mayolo, Huaraz, Peru
f Hospital Germans Trias i Pujol, Badalona, Spain
Article information
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Figures (2)
Tables (3)
Table 1. Characteristics of patients with early and advanced gastric cancer.
Table 2. Characteristics of patients with EGC and curative potential if ESD had been performed.
Table 3. Frequency of EGC in published series in Spain.
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Abstract
Introduction

Gastric cancer (GC) incidence is currently decreasing; however, survival is still low. Early GC (EGC) has better prognosis and it could be cured by endoscopic methods.

Patients and methods

Observational study of a retrospective cohort of all patients with GC during a five-year period in a health area of Spain. EGC diagnosis was defined as mucosal or submucosal (T1) cancers regardless of lymph node involvement, whereas the advanced GC was T2–T4.

Results

209 patients were included, and 26 (12%) of them were EGC. There was no difference between EGC and advanced GC in age, sex, HP infection, precancerous lesions or histological type. Other characteristics of EGC were different from advanced GC: location (antrum and incisura in 76% vs. 38%, p=0.01), alarm symptoms (69% vs. 90%, p<0.01), curative treatment (100% vs. 30%, p<0.01), performance status (PS 0–1: 92% vs. 75%, p=0.03) and survival (85% vs. 20%, p<0.001). Among patients who received curative treatment, 98% (79/81) underwent surgery and 2% (2/81) were treated by mucosectomy. Seven (27%) patients with EGC could have benefited from treatment by endoscopic submucosal resection.

Discussion

EGC frequency was low (12% of GCs) in our health area. EGC had a high percentage of alarm symptoms, and was located in the distal third of the stomach (antrum and incisura) and had better prognosis compared to advanced GC. Strategies to increase detection and endoscopic treatment of EGC should be implemented.

Keywords:
Gastric cancer
Early diagnosis
Characteristics
Endoscopic treatment
Resumen
Introducción

En la actualidad, la incidencia del cáncer gástrico (CG) está disminuyendo, sin embargo, la supervivencia continúa siendo baja. El cáncer gástrico precoz (CGP) ofrece un mejor pronóstico y la posibilidad de tratamientos endoscópicos curativos.

Pacientes y métodos

Estudio observacional de una cohorte retrospectiva de todos los pacientes con CG en un periodo de 5años en un área sanitaria de España. El CGP incluyó los pacientes con afectación mucosa o submucosa (T1) independientemente de la afectación ganglionar, mientras que el avanzado fueron los T2-T4.

Resultados

Se incluyeron 209 pacientes de los cuales 26 (12%) fueron CGP. El CGP no tuvo diferencias en comparación con el avanzado en la edad, sexo, infección por HP, lesiones premalignas ni tipo histológico; sin embargo, tuvo diferencias significativas en la localización (antro e incisura en un 76% vs. 38%, p=0,01), síntomas de alarma (69% vs. 90%, p<0,01), tratamiento con intención curativa (100% vs. 30%, p<0,01), performance status (PS 0-1: 92% vs. 75%, p=0,03) y supervivencia (85% vs. 20%, p<0,001). Entre los pacientes tratados con intención curativa, el 98% (79/81) fueron operados y el 2% (2/81) fueron tratados con mucosectomía. Siete (27%) pacientes con CGP se hubiesen podido beneficiar de disección submucosa.

Discusión

La frecuencia del CGP fue baja en nuestra área sanitaria (12% de los CG). El CGP tuvo síntomas de alarma en un alto porcentaje, se localizó en el tercio distal del estómago (antro e incisura) y tuvo mejor pronóstico en relación con el CG avanzado. Se deben implementar medidas para incrementar la detección y tratamiento endoscópico del CGP.

Palabras clave:
Cáncer gástrico
Diagnóstico temprano
Características
Tratamiento endoscópico

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