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Franck C, Zimmermann N, Goni E, et al. Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer. J Gastrointestin Liver Dis. 2021;doi: 10.15403/jgld-3795.
Franck, C., Zimmermann, N., Goni, E., Lippert, H., Ridwelski, K., Kruschewski, M., Kreuser, N., Lingohr, P., Schildberg, C., Vassos, N., Waidmann, O., Peitz, U., Lang, H., Grmminger, P. P., Bruns, C., Veits, L., Vieth, M., Moehler, M., Lordick, F., Gockel, I., Schumacher, J., Malfertheiner, P., & Venerito, M. (2021). Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer. Journal of gastrointestinal and liver diseases : JGLD, . https://doi.org/10.15403/jgld-3795
Franck, Caspar, et al. "Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer." Journal of gastrointestinal and liver diseases : JGLD vol. (2021). doi: https://doi.org/10.15403/jgld-3795
Franck C, Zimmermann N, Goni E, Lippert H, Ridwelski K, Kruschewski M, Kreuser N, Lingohr P, Schildberg C, Vassos N, Waidmann O, Peitz U, Lang H, Grmminger PP, Bruns C, Veits L, Vieth M, Moehler M, Lordick F, Gockel I, Schumacher J, Malfertheiner P, Venerito M. Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer. J Gastrointestin Liver Dis. 2021 Nov 08; doi: 10.15403/jgld-3795. Epub 2021 Nov 08. PMID: 34752588.
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J Gastrointestin Liver Dis. 2021 Nov 08; doi: 10.15403/jgld-3795. Epub 2021 Nov 08.

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

Journal of gastrointestinal and liver diseases : JGLD

Caspar Franck, Nadja Zimmermann, Elisabetta Goni, Hans Lippert, Karsten Ridwelski, Martin Kruschewski, Nicole Kreuser, Philipp Lingohr, Claus Schildberg, Nikolaos Vassos, Oliver Waidmann, Ulrich Peitz, Hauke Lang, Peter P Grmminger, Christiane Bruns, Lothar Veits, Michael Vieth, Markus Moehler, Florian Lordick, Ines Gockel, Johannes Schumacher, Peter Malfertheiner, Marino Venerito

Affiliations

  1. Deptartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
  2. Department of Internal Medicine II, Ludwig Maximilians University Hospital, Munich, Germany.
  3. Department of General, Visceral, Vascular and Transplantation Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany.
  4. Department of Surgery, Municipal Hospital, Magdeburg, Germany.
  5. Department for General, Visceral und Thoracic surgery, Frankfurt (Oder) Municipal Hospital, Frankfurt (Oder), Germany.
  6. Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
  7. Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany.
  8. Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany.
  9. Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, Mannheim University Medical Center, University Heidelberg, Mannheim, Germany.
  10. Department of Gastroenterology and Hepatology, University Hospital of Frankfurt a. Main, Frankfurt, Germany.
  11. Department of Gastroenterology, Raphaelsklinik Muenster, Muenster, Germany.
  12. Department of Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
  13. Deparment of General, Visceral, Tumor and Transplantation Surgery, University Hospital Cologne, Cologne, Germany.
  14. Institute of Pathology, University of Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany.
  15. First Medical Clinic and Policlinic, University Medical Center of Johannes Gutenberg-University Mainz, Mainz, Germany.
  16. Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany.
  17. Center for Human Genetics, Philipps University Marburg, Marburg, Germany.
  18. 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.
  19. Magdeburg, Germany. [email protected].

PMID: 34752588 DOI: 10.15403/jgld-3795

Abstract

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.

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