Late Presentation and Treatment Outcomes of Gastric Carcinoma in Jordanian Population.

Abstract

Majority of the patients with gastric cancer in resource-restricted country, like Jordan, are diagnosed with advanced-stage disease with poor treatment outcomes. This study explores the state of gastric cancer in Jordan and outlines strategies for disease control. Data on disease stage at presentation and treatment outcomes were obtained from the King Hussein Cancer Center registry. Patients were staged according to the US SEER staging system, which classifies gastric cancer into localized, regional and distant. Overall survival (OS) was reported for the whole group and stratified by age at diagnosis, stage, sex, and year of diagnosis, and compared with published data from the United States and Asia. During the study period, a total of 888 patients were treated and followed up at our institution. The majority (n = 503, 56.6%) were diagnosed with distant metastases); 315 (35.5%) had regional disease and only a minority (n = 70, 7.9%) had localized disease. After a median follow-up of 5.7 (1.3-18.7) years, the 5-year OS for the entire cohort was 18.1% (95% CI, 15.5% to 20.8%), varying by stage; 62.9% (95% CI, 50.7% to 74.3%) for localized disease, 34.1% (95% CI, 28.7% to 39.8%) for regional disease, and only 1.86% (95% CI, 0.80% to 3.36%) for distant metastasis, <i>P</i> < .0001. Patients' age at diagnosis (<40 <i>v</i> ≥40 years), sex, or year at diagnosis (recent years <i>v</i> >10 years ago) had no significant impact on 5-year OS. Although gastric cancer is relatively uncommon in Jordan, fewer than 10% of patients are diagnosed at an early, localized disease, contributing to persistently poor treatment outcomes with little improvement over time. National initiatives and strategies to improve treatment outcome are urgently needed.