Language

English

Publication Date

1-1-2023

Journal

PLoS One

DOI

10.1371/journal.pone.0291926

PMID

37729185

PMCID

PMC10511075

PubMedCentral® Posted Date

9-20-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Gastric cancer remains the fourth leading cause of cancer-related death worldwide. Significant number of gastric cancer patients presented with bleeding.

Objective: This study aimed to identify risk factors and overall survival rates of bleeding gastric cancer patients.

Methods: This retrospective cohort study was conducted between 2007-2022 at tertiary care center in Thailand. Clinical information, endoscopic findings and histological type were extensively reviewed and were compared between bleeders and non-bleeders. Patients were monitored for at least 5 years.

Results: There were 20,981 patients who underwent upper gastrointestinal endoscopy during study period. Total of 201 gastric cancer patients were included in this study, 21 were excluded due to incomplete medical records. 180 gastric cancer patients were included with mean age of 60.5±14.3 years. There were 65 (36.1%) patients with gastrointestinal bleeding. Hypertension and chronic kidney disease were significantly more common in bleeders than non-bleeders (43.1% vs 23.5%, OR2.51, 95%CI 1.14.-5.52, p = 0.022; and 16.9% vs 5.2%, OR2.00, 95%CI 1.56-6.63, p = 0.025, respectively). current H. pylori infection was also significantly more common in bleeders than non-bleeders (84.6% vs. 55.7%, OR 4.39, 95%CI 1.90-10.12, p< 0.001). Median overall survival of bleeders was significantly lower than non-bleeders (7±0.93 vs 10±2.10 months, p = 0.001).

Conclusions: Bleeding gastric cancer was not an uncommon condition. Majority of patients presented at advanced stage with grave prognosis. Male gender, hypertension, chronic kidney disease, and current H. pylori infection were reliable predictors for bleeding. Early diagnosis and prompt treatment are the key to improve clinical outcome.

Keywords

Humans, Male, Middle Aged, Aged, Retrospective Studies, Gastrointestinal Hemorrhage, Prognosis, Stomach Neoplasms, Hypertension, Renal Insufficiency, Chronic

Published Open-Access

yes

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