Clinico-Pathological characteristics and outcomes of gastric cancer among patients at Kenyatta National Hospital

Abstract

Background: Despite a decrease in new cases, gastric cancer (GC) is the third-highest cause of death from cancer around the world. According to the Globocan data 2012, Kenya is estimated to have the highest incidence of gastric cancer seen on the continent of Africa. Clinical data on gastric cancer in Kenya is lacking. Aims: The study describes the clinicopathological characteristics and outcomes of gastric cancer patients seen at the Kenyatta National Hospital (KNH) between January 2014 to December 2018. Methods: This was a hospital-based retrospective study. We included consecutive patients with a histological diagnosis of gastric cancer from January 2014 December 2018. Patients’ socio-demographic data, clinical and pathological characteristic and outcome were recorded into the Data Collection form and analyzed. The mortality rate was calculated at 6 months and the survival rate throughout the period of study. Results: We enrolled 438 confirmed gastric malignancy. The male to female ratio was 3:2, with a median age among enrolled patients of 58 years. The commonest presenting complaints were abdominal pain, vomiting and weight loss. Approximately three-quarters (n=298,74%) patients had advanced disease (stage III and IV). Anatomically antral tumours were the most commonly seen in 196 (46.4%) while adenocarcinoma was the commonest histological type found in, 405 (93.5%) patients. Diffuse subtype was seen in 144 (58.8%) while intestinal subtype was present in 72 (29.4%). 153 (43.3%) of the patients had surgery and 267 (75.9 %) of the patients had chemotherapy with the majority having palliative chemotherapy in 197 (53.1%). Platinum-based chemotherapy was the therapy of choice in 197 (67.2 %) patients with EOX 76 (25.9 %) being the commonest regimen of prescribed. Conclusion: Gastric cancer in our population present at a younger age and in advanced stages resulting in poor outcomes. Early diagnosis and curative intent in treatment will likely improve survival.