Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer.


Journal

Journal of gastrointestinal and liver diseases : JGLD
ISSN: 1842-1121
Titre abrégé: J Gastrointestin Liver Dis
Pays: Romania
ID NLM: 101272825

Informations de publication

Date de publication:
21 12 2021
Historique:
pubmed: 10 11 2021
medline: 28 4 2022
entrez: 9 11 2021
Statut: epublish

Résumé

Symptoms of patients with gastric cancer (GC) are often unspecific and differences in symptoms between patients with cardia and non-cardia GC have been poorly investigated. We aimed to characterize symptoms of patients with cardia and non-cardia GC. Patients with cardia (Siewert type II and III) and non-cardia GC were recruited in the German multicenter cohort of the Gastric Cancer Research (staR) study between 2013 and 2017. Alarm, dyspeptic and reflux symptoms at the time of presentation were documented using a self-administered questionnaire. A completed self-administered questionnaire was available for 568/759 recruited patients (132 cardia GC, 436 non-cardia GC, male 61%, mean age 64 years). Dyspeptic symptoms were more common in patients with non-cardia GC (69.0 vs. 54.5%, p=0.0024). Cardia GC patients reported more frequently alarm symptoms (69.7 vs. 44.7%, p<0.0001), and were more likely to have Union for International Cancer Control (UICC) stage III-IV (54.1vs. 38.9%, p=0.0034). Especially, dysphagia and weight loss were more common in patients with cardia GC (49.2 vs. 6.4 %, p<0.0001 and 37.1 vs. 25.7%, p=0.02, respectively). No differences between the two groups were observed with respect to reflux symptoms. Patients with alarm symptoms were more likely to have UICC stage III-IV at presentation (69.4 vs. 42.9%, p<0.0001). In clinical practice the symptom pattern at presentation may serve as a hint for tumor localization. Despite the fact that they are common in the general population, dyspeptic symptoms offer a chance for earlier GC detection. Thus, in patients with dyspeptic symptoms who fail empiric approaches, endoscopy should not be delayed.

Sections du résumé

BACKGROUND AND AIMS
Symptoms of patients with gastric cancer (GC) are often unspecific and differences in symptoms between patients with cardia and non-cardia GC have been poorly investigated. We aimed to characterize symptoms of patients with cardia and non-cardia GC.
METHODS
Patients with cardia (Siewert type II and III) and non-cardia GC were recruited in the German multicenter cohort of the Gastric Cancer Research (staR) study between 2013 and 2017. Alarm, dyspeptic and reflux symptoms at the time of presentation were documented using a self-administered questionnaire.
RESULTS
A completed self-administered questionnaire was available for 568/759 recruited patients (132 cardia GC, 436 non-cardia GC, male 61%, mean age 64 years). Dyspeptic symptoms were more common in patients with non-cardia GC (69.0 vs. 54.5%, p=0.0024). Cardia GC patients reported more frequently alarm symptoms (69.7 vs. 44.7%, p<0.0001), and were more likely to have Union for International Cancer Control (UICC) stage III-IV (54.1vs. 38.9%, p=0.0034). Especially, dysphagia and weight loss were more common in patients with cardia GC (49.2 vs. 6.4 %, p<0.0001 and 37.1 vs. 25.7%, p=0.02, respectively). No differences between the two groups were observed with respect to reflux symptoms. Patients with alarm symptoms were more likely to have UICC stage III-IV at presentation (69.4 vs. 42.9%, p<0.0001).
CONCLUSIONS
In clinical practice the symptom pattern at presentation may serve as a hint for tumor localization. Despite the fact that they are common in the general population, dyspeptic symptoms offer a chance for earlier GC detection. Thus, in patients with dyspeptic symptoms who fail empiric approaches, endoscopy should not be delayed.

Identifiants

pubmed: 34752588
doi: 10.15403/jgld-3795
doi:

Types de publication

Letter Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

431-437

Auteurs

Caspar Franck (C)

Deptartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.

Nadja Zimmermann (N)

Deptartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.

Elisabetta Goni (E)

Department of Internal Medicine II, Ludwig Maximilians University Hospital, Munich, Germany.

Hans Lippert (H)

Department of General, Visceral, Vascular and Transplantation Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany.

Karsten Ridwelski (K)

Department of Surgery, Municipal Hospital, Magdeburg, Germany.

Martin Kruschewski (M)

Department for General, Visceral und Thoracic surgery, Frankfurt (Oder) Municipal Hospital, Frankfurt (Oder), Germany.

Nicole Kreuser (N)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.

Philipp Lingohr (P)

Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.

Claus Schildberg (C)

Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany.

Nikolaos Vassos (N)

Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, Mannheim University Medical Center, University Heidelberg, Mannheim, Germany.

Oliver Waidmann (O)

Department of Gastroenterology and Hepatology, University Hospital of Frankfurt a. Main, Frankfurt, Germany.

Ulrich Peitz (U)

Department of Gastroenterology, Raphaelsklinik Muenster, Muenster, Germany.

Hauke Lang (H)

Department of Gastroenterology, Raphaelsklinik Muenster, Muenster, Germany.

Peter P Grmminger (PP)

Department of Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

Christiane Bruns (C)

Deparment of General, Visceral, Tumor and Transplantation Surgery, University Hospital Cologne, Cologne, Germany.

Lothar Veits (L)

Institute of Pathology, University of Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany.

Michael Vieth (M)

Institute of Pathology, University of Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany.

Markus Moehler (M)

First Medical Clinic and Policlinic, University Medical Center of Johannes Gutenberg-University Mainz, Mainz, Germany.

Florian Lordick (F)

Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany.

Ines Gockel (I)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.

Johannes Schumacher (J)

Center for Human Genetics, Philipps University Marburg, Marburg, Germany.

Peter Malfertheiner (P)

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg; 2) Department of Internal Medicine II, Ludwig Maximilians University Hospital, Munich, Germany.

Marino Venerito (M)

Magdeburg, Germany. m.venerito@med.ovgu.de.

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