Three Years Treatment Analysis Of Surgical Gastric Cancer In A Secondary Level Hospital

Objective:Gastric carcinoma is a common malignancy with high morbidity and mortality, inChina. So it seems very important to deal with patients with standardized diagnosis andtreatment, which can improve the therapeutic effect, the quality of life and the survival. Inthis study, through the analysis of surgical treatment of gastric cancer in Gaochun People’sHospital from2011January to2013December, we try to find the gap between our hospitaland the international standard, and to more effectively improve the diagnosis and treatmentof gastric cancer.Methods:A retrospective analysis of patients with gastric cancer was carried out in GaochunPeople’s Hospital of Nanjing Province, from2011January to2013December. By statisticsgeneral information of patients, preoperative examination, surgical approach, pathology,postoperative treatment, follow-up and curative efficacy, we compared our diagnosis andtreatment path with the "normalization of gastric cancer treatment guidelines (Trial)" and"NCCN Clinical Practice Guidelines in gastric cancer (Chinese Version)", and analyzedthe gap between our path and guidelines.Results:There were306patients in the three years, including242male patients,164femalepatients. All cases had pathological biopsy, and most patients were found throughgastroscopy, some were diagnosed by internal medicine examination, a small number ofpatients were revealed by physical examination.Preoperative examination included blood, biochemistry, tumor markers, abdominalCT, chest and upper gastrointestinal contrast. Preoperative tumor markers ratio reached92.81%, upper gastrointestinal contrast examination ratio reached90.52%, and theproportion of abdominal CT examination was maintained above94.77%. But there were 4.25%patients without full chest X-ray or chest CT images before operation. Endoscopicultrasound, laparoscopy, MRI examination had not been carried out as a routinepreoperative examination in our hospital. Curative and palliative resection ratio for gastriccancer had reached to95.1%in our hospital in the recent three years. And most of themwere the traditional laparotomy or thoracotomy operation. Yet endoscopic andlaparoscopic operations, such as EMR or ESD had not been undertaken. There were someproblems about over-treatment and lack of treatment in the Perioperative period. More andmore patients had been received the auxiliary treatment in the past three years, and theproportion increased year by year. The administration of chemotherapy scheme was basedon FOLFOX and XELOX solutions.Unfortunately most patients did not pay attention on postoperative examination andregular follow-up. There were47%patients received regular monitoring of tumor markers(CEA, CA19-9),25.2%patients received postoperative examination of abdominal CT, andjust5.9%patients received postoperative endoscopy gastroscopy.Conclusion:Compared with international and domestic gastric cancer diagnosis guides, we foundthat the gastric cancer treatment model did not change gradually, which means there arestill deficiencies in our hospital treatment model. Fortunately more and more attention hasbeen paid to the tumor multidisciplinary treatment modalities in our hospital.