Adnan Yousaf, Mushtaq Ahmad, Rashid Waheed, Muhammad Muslim, Mahmud Aurangzeb, Nisar Ahmed, Asad Maroof.
Surgical Outcome Of Upper Gastrointestinal Malignancies.
J Med Sci Jan ;24(1):32-5.

Objective: To evaluate the surgical outcome of upper Gastrointestinal (GI) malignancies. Material and Methods: This cross-sectional study was conducted at Department of Surgery, Khyber Teaching Hospital, Peshawar from January 2012 to December 2014. One hundred and ninty patients of either gender, diagnosed as having upper GI malignancy (esophageal, gastric, pancreatic, gall bladder) on the basis of histopathology were included in the study. Detailed information was recorded about the age and gender distribution, staging of respective cancer, surgical management, and post-operative morbidity and mortality. Results: Of the 190 patients with upper GI malignancies, 88 (46%) had esophageal carcinoma; 47 (25%) had gastric carcinoma, 27 (14%) had pancreatic carcinoma and 28 (15%) had gall bladder cancer. 80.68% of the esophageal cancers were adenocarcinomas and 19.31% were squamous cell carcinomas based on histopathology reports. Males were predominantly affected (69.31%). Majority (73.86%) patients were diagnosed in stage III esophageal cancer. Transhiatal esophagectomy was the surgery of choice in 78.40% of the patients with esophageal cancer. Post-operatively, 30 day mortality was 11%. Among the gastric cancer patients, 65% had adenocarcinoma; 20% had squamous cell carcinoma; 10% had Gastrointestinal Stromal Tumor (GIST); and 5% had gastric lymphoma. Again, males were predominantly involved (55%). Majority (56.52%) of the patients were diagnosed in stage IV of gastric carcinoma. Only 10 patients underwent surgery, while the remaining 13 received palliative therapy. 30-day post-operative mortality was 20%. Three of the 27 pancreatic cancers were adenocarcinomas. Males were predominantly affected (66.66%). Five patients underwent Whipple’s Procedure, of whom 2 expired. Female to male ratio in gall bladder cancer was 3:1 (75%: 25%). Ninty percent of the patients presented with advanced disease. Six month survival rate was <2%. Conclusion: Esophageal and gastric carcinomas are the most frequently encountered upper GI malignancies. If diagnosed at an early stage, all malignancies carry a better prognosis with appropriate surgical intervention. Late presentation carries a poor prognosis.

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