Advanced gastric cancer in jordan from 2004 to 2008: a study of epidemiology and outcomes

Gastrointest Cancer Res. 2011 Jul;4(4):122-7.

Abstract

Background: WE REPORT THE EPIDEMIOLOGIC FEATURES AND THE TREATMENT EXPERIENCE OF ADVANCED GASTRIC CANCER (GC) AT KING HUSSEIN CANCER CENTER (KHCC) IN JORDAN, AND WE RETROSPECTIVELY COMPARE OUTCOMES OF TWO DIFFERENT REGIMENS: DCF (docetaxel/cisplatin/5-fluorouracil) vs. ECF (epirubicin/cisplatin/5-fluorouracil).

Methods: Charts of 162 patients with inoperable GC treated between January 2004 and December 2008 were reviewed. A total 143 patients received chemotherapy (ECF = 113; DCF = 30). Choice of regimen was changed from ECF to DCF on January 2008 according to KHCC guidelines.

Results: The median patient age was 59 years, with a male:female ratio of 1.8:1. Lymph nodes (67.9%) and liver (49.4%) were the most common sites of metastasis. Primary disease site was stomach in 78.4%, gastroesophageal junction in 16.7%, lower esophagus in 4.9%. Poorly differentiated histology was predominant (46.9%). Anemia (53.7%), pain (48.1%), and reflux (44.4%) were the most common presenting symptoms. Helicobacter pylori infection was present in 79%. Average time between initial symptom and diagnosis was 6.0 months. The overall response rate (ORR) was 59.3% with DCF and 32.6% with ECF (P = .01). Time to tumor progression (TTP) was 6.9 months with DCF and 5.9 months with ECF (P = .005). Median survival was 11.0 months with DCF and 10.2 months with ECF (P = .17).

Conclusion: Some epidemiologic features of GC in Jordan mimic those of high-risk areas. Our outcomes of chemotherapy are comparable to internationally reported data and suggest superiority of DCF over ECF in terms of ORR and TTP.