Cancer of the Upper and Lower Gastrointestinal Tract - Analysis of Resective Treatment

Background. Surgical excision is the best therapeutic option for esophageal, gastric, and colorectal cancer. Many authors believe that the low percentage of resections in patients with cancer of the proximal gastrointestinal tract is primarily attributable to delayed diagnosis. Objectives. The aim of this study was to compare resective treatment for esophageal, gastric, and colorectal cancer with cancer staging on admission to the surgical unit. Stage of disease was evaluated using the TNM system. Material and Methods. The analysis involved 323 patients with esophageal cancer (158), gastric cancer (98), and colorectal cancer (67) referred for surgical treatment in 2005-2006. Results. The majority of the patients were male (76.5%), with significantly more males in the groups with esophageal and gastric cancer (p < 0.001). There were no gender-related differences among patients with colorectal cancer (p < 0.0001). The stage of disease differed for the different cancers. In the group with esophageal cancer, 0.6, 3.8, 1.3, and 94.3% of the patients were qualified to stages 1, 2, 3, and 4 of the TNM system, respectively. In the gastric cancer group, stages 1, 2A/2B, 3, and 4 involved 0, 7.1, 4.1, and 88.8% of the patients, respectively. In the colorectal cancer group, the majority of patients (94%) had stages 1, 2, and 3. Resection surgery was the therapeutic modality in 5.7% of the esophageal, 11.2% of the gastric cancers, and 94% of the colorectal cancers. The difference in the percentage of resection surgery for esophageal cancer compared with gastric cancer was on the borderline of statistical significance (p = 0.1). There was a statistically significant difference in the numbers of resections for upper digestive tract and colorectal cancer (p < 0.001). Conclusions. The authors suggest that the popularization of screening examinations for esophageal and gastric cancer may have a positive effect on the early diagnosis of cancer in the upper gastrointestinal tract (Adv Clin Exp Med 2010, 19, 1, 105-111).