EXPERIENCE IN METASTATIC GASTRIC CANCER AT NATIONAL CANCER INSTITUTE OF COLOMBIA BETWEEN 2014 TO 2016
DOI:
https://doi.org/10.35509/01239015.760Keywords:
Gastric cancer, metastases, survival, mortalityAbstract
ABSTRACT
Background: Gastric cancer is a leading cause of cancer related morbidity and mortality worldwide accounting for more than 1 million of newly diagnosed cases and seven hundred thousand deaths every year. It is the first cause of cancer related mortality in Colombia, besides it is most often diagnosed at an advanced stage which influences a somber prognosis. The aim of the present manuscript is to describe sociodemographic, clinic and histopathological characteristics of patients with metastatic gastric cancer and to determinate survival after first-line palliative chemotherapy at National Cancer Institute of Colombia between 2014 and 2016.
Materials and Methods: This is a retrospective case series of patients diagnosed with metastatic gastric adenocarcinoma confirmed histologically who were treated with first-line chemotherapy between 2014 and 2016 period. Sociodemographic, clinic and management characteristics are described. Overall survival and progression-free survival evaluation was done too by using descriptive statistics and the Kaplan Meier method. Cox regression model was used to analyze the risk factors which influence survival.
Results: 118 patients fulfilled eligibility criteria, they had mean age of 58-years old, 73% lived in urban area and 25% in rural area. This study found in order of frequency intestinal histological subtype (48%) followed by diffuse subtype (25%). Respect to differentiation poor differentiate grade were in 55% of cases and moderate grade in 35% of cases. HER 2-receptor overexpression was reported in 10% of patients. The most common sites of metastasis were peritoneum (49%) and liver (42%). First-line chemotherapy more used were platinum-based doublets in 81% of patients, between these, cisplatine plus capecitabine (XP) 70%, carboplatine plus 5-fluorouracil (CBP-5FU) 25%, oxaliplatin plus oxaliplatin (CAPOX) 4% and oxaliplatin plus 5-fluorouracil (FOLFOX) 1%. 39% of patients were treated with second line chemotherapy and just 9% with three or more lines. Mean overall survival (OS) was 6.7 months and mean progression-free survival (PFS) of 4.9 months. 1-year and 3-year OS was of 26.2% and 2.5% respectively.
Conclusions: Demographic characteristics of patients studied with metastatic gastric cancer in this manuscript were similar to that reported in general world literature, however a lesser overall survival and progression-free survival was found, some of the reasons are greater number of patients with ECOG performance status 2 unlike clinical trials, also delay between chemotherapy order and application and differences of actual management with treatment schemes used in patients of this study.
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