RESUMO
INTRODUCTION: Stomach cancer is the third most common cause of death worldwide, mainly affecting people with low socioeconomic status. In Brazil, we expect 20,390 new cases of stomach cancer in 2014, in both sexes, and according to the proportional distribution of the ten most prevalent types of cancer (except non-melanoma skin cancer) expected for 2014, this type of cancer was estimated to be the fourth most common in men and sixth in women. AIM: To investigate and analyse the clinical and epidemiological profile of deaths caused by stomach adenocarcinoma in patients enrolled in the National Cancer Institute, Brazil. METHODS: Cross-sectional study, with samples which consisted of data from the medical records of deaths from stomach cancer, enrolled in the period from 1 February 2009 to 31 March 2012 and who had died as of 30 April 2012. STATISTICAL ANALYSIS USED: The Epi Info ®, version 7. RESULTS: We included 264 cases, mostly male. The mean age was 61.7 years. They were smokers, drinkers, white, and married, with elementary education and an income of one minimum salary. They had advanced stage disease (E IV), with symptoms characteristic of this phase, and the majority died within six months. CONCLUSION: The findings are similar to other studies. The advanced stage of the disease at the time of admission of the patients reflects the difficulty for users of the Unified Health System to access early diagnosis, demonstrating the need for efforts to identify groups and risk factors for the development of gastric cancer. Training of health professionals will facilitate planning and implementation of programmes for the prevention and control of disease, considering socioeconomic conditions, as seen in the sample, which is common among most users.
RESUMO
Background: The AJCC 2002 staging system recommends the study of at least 15 lymph nodes in the surgical specimen. Thisnumber varies and sometimes it is not achieved since it is influenced by surgeons, pathologists and patients and may modifythe patients staging and survival. Methods: This is an observational study of 201 patients with gastric cancer submitted tosurgery in the period of January 1997 to December 2001, and followed-up until July 2003 in the Brazilian National CancerInstitute. Data related to surgeon and pathologist productivity as well as survival were analyzed. Results: All patients that haveundergone D2 lymphadenectomy had more than 15 lymph nodes. The factors related to varied number of lymph nodes were:surgeon (31.5±9.3 to 43.8 ±16.8); surgical procedure (total gastrectomy, 41.4 ±15.5); extended resection (40.8 ±15.9);pN3 and stage IV (55.1 ±15.8). Multivariate analysis showed the surgeon as an independent variable (p=0,02). The morelymph nodes studied, the more nodal metastasis found (p=0.01), but this fact has been significant only in pT3 patients(p=0.007). The variables related to survival have been surgical procedure, resection of another organ, site of the tumor; pT andpN. The independent variables have been pT (p=0,01) and pN (p=0,004). Conclusion: The surgeons technique is the mainfactor related to number of lymph nodes in the surgical specimen and for accurate staging of pT3 patients over 30 lymph nodesarenecessary.
