Changing trends in the proportions of small (≤ 2 cm) proximal and non-proximal gastric carcinomas treated at a high-volume tertiary medical center in China

J Dig Dis. 2014 Jul;15(7):359-66. doi: 10.1111/1751-2980.12151.

Abstract

Objective: Guided by the recently established histological criteria of the gastroesophageal junction (GEJ), we aimed to investigate and compare trends in the proportions of small (≤ 2 cm) proximal gastric carcinoma (PGC) vs non-PGC (NPGC) in Chinese patients over an 8-year period.

Methods: The study was conducted with consecutive surgical resected specimens of small PGC that was located within 3 cm below the GEJ and NPGC (located at all other gastric regions) treated at a single medical center in China. Differences in proportions between the two groups were compared.

Results: Among all 313 cases, 111 (35.5%) were classified as PGC and the remaining 202 (64.5%) as NPGC. Patients with PGC were significantly elder than those with NPGC, and none aged younger than 40 years. The proportions of PGC significantly and progressively increased from 16% in 2004 to 45% in 2011, in contrast to a steady decreasing trend for NPGC from 84% to 55% over the same period. The difference in trends between the two groups approached, but was not at a statistically significant level (P = 0.08). Proportions of small cancers in the gastric corpus and in female patients remained low and stable, in contrast to a significantly higher proportion in male patients (P < 0.05).

Conclusions: Our data showed a significantly upward-shifting trend in the proportions of small PGC, primarily in elderly male patients, in contrast to a downward shifting trend in NPGC over the most recent 8-year period in Chinese patients.

Keywords: China; gastroesophageal junction; proximal gastric carcinoma; stomach neoplasms.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Esophagogastric Junction
  • Female
  • Gastrectomy
  • Humans
  • Male
  • Middle Aged
  • Sex Factors
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / pathology*