Clinical epidemiology and mortality risk factors of gastric cancer in a sub-Saharan African setting: a retrospective analysis of 120 cases in Yaoundé (Cameroon)

Abstract

INTRODUCTION: In sub-Saharan Africa, there is scare published data on cancer in general and gastric cancer in particular. METHODS: we conducted a multicenter retrospectiveanalysis of the medical records of patients followed for gastric cancer in 5 hospital departments in the city of Yaoundé (Cameroon) over 6 years. RESULTS: we recorded atotal of 120 patients with amean age of 53.4 ± 13.7 years.There were 62 females (51.7%).The most common risk factors for gastric cancer in our patientswas Helicobacter pylori infection (59 cases, 49.1%). Seventy-six patients (63.3%) consulted within 1 to 6 months of symptoms onsetat the forefront of which chronic epigastralgia (74.1%). At endoscopy, the tumor was mostly located at the antrum and was locally advanced or metastatic in 25.8% and 58.4 of cases respectively. Adenocarcinoma was the main histologic type found in 105 (87.5%) cases.Curative treatment could only be implemented in 26.7% of patients.We noted a total of 85 deaths (70.8%) with a mean survival time of 5.91 ± 7.51 months. Survival rate at 3 and 5 years was 10.1% and 4.6%,respectively. On multivariable analysis, variables independently associated with overall survival included: WHO stage 3 performance status (p = 0.042), palpable epigastric mass on examination (p = 0.042), pyloric localization (p = 0.007), and liver metastasis (p = 0.012). CONCLUSION: clinical epidemiology of gastric cancer in our study is comparable to those of other African studies with a predominance of locally advanced/metastatic forms. Prognosis is grim with diagnostic delay behind all of the identified mortality risk factors.

Keywords

• gastric cancer
• clinical epidemiology
• survival
• mortality risk factors
• cameroon