Dushmanta Kumar Sethi1 , Koresh Prasad Dash2 , Vattikulla Rajesh3
BACKGROUND The overall 5-year survival of patients with gastric cancer has not changed significantly over the past three decades and remains at 10-15% (U.I.C.C. report). The consistently poor results of surgical treatment have led to the conduct of several adjuvant chemotherapeutic trials. Cytotoxic drugs have also been used for advanced carcinoma of stomach where surgery is not undertaken either due to contraindication for surgery or patient’s refusal. Though the results of chemotherapy are not encouraging, still many cytotoxic regimens are under study throughout the world. India being a poor country, mass screening is quite expensive is not possible. Therefore, the management of advanced carcinoma of stomach has become important. This study has been designed to evaluate the incidence of advanced gastric carcinoma in surgical ward of M.K.C.G. Medical College and Hospital, Berhampur, over a period of 2 years including period of follow up. METHODS The present work is an observation on the different modalities of management in case of advanced carcinoma of stomach admitted to the surgical wards of MKCG Medical College Hospital, Berhampur, for a period extending from July-2017 to June-2019 including period of follow up. Seventy-five cases of carcinoma of stomach were admitted to the surgical wards of M.K.C.G. Medical College, Berhampur from July 2017 to June 2019. All of them were in the advanced stage of the disease and were taken into consideration in the present study, after confirmation of diagnosis on the basis of presenting symptoms, physical sign and investigations. RESULTS Only 44 cases were studied in the initial one-year i.e. between July 2017 to June 2018 so one year follow up was done and median survival for one year follow up was maximum for partial gastrectomy with 5FU (8.7 months) followed by combined ECF regimen group (6.3 months). Single drug chemotherapy 5FU group and palliative GJ + 5FU group had almost similar survival rates (5.1 months). CONCLUSIONS The patients were followed up till the end of study period and their medium duration of survival found out. 10 patients who were getting 5 F.U. as single agent therapy and were available to the follow up showed a medium survival time of 5.1 months. 16 patients were followed up who were getting ECF regimen and median duration of survival in this group was 6.3 months. Median survival duration of 8.7 months was found in 6 patients who were getting 5 F.U. after palliative partial gastrectomy and were available for follow up. Median duration survival of 5.1 months was found in 20 patients who were getting 5 F.U. after gastrojejunostomy and available for follow-up.
