Nicolas Chapelle1,2,3, Anne-Marie Bouvier1,2,3, Sylvain Manfredi1,2,3, Antoine Drouillard1,2,3, Come Lepage1,2,3, Jean Faivre1,2,3, Valerie Jooste4,5,6. 1. Registre Bourguignon des Cancers Digestifs, INSERM, LNC UMR866, Dijon, France. 2. Université Bourgogne Franche-Comté, LNC UMR866, Dijon, France. 3. CHU Dijon Bourgogne, Dijon, France. 4. Registre Bourguignon des Cancers Digestifs, INSERM, LNC UMR866, Dijon, France. vjooste@u-bourgogne.fr. 5. Université Bourgogne Franche-Comté, LNC UMR866, Dijon, France. vjooste@u-bourgogne.fr. 6. CHU Dijon Bourgogne, Dijon, France. vjooste@u-bourgogne.fr.
Abstract
BACKGROUND: Little is known about the epidemiology of early gastric cancer (EGC) in Western countries. The aim of this study was to analyze trends in the incidence, management, and survival of EGC in a well-defined population over a 30 year period. METHODS: Data were obtained from the population-based cancer Registry of Burgundy (France). Incidence rates were calculated by sex, age, and 10 year period of diagnosis. Net survival rates were calculated and a multivariate relative survival analysis performed. RESULTS: EGC represented 6.7 % of gastric cancer diagnosed between 1982 and 2011. Age-standardized incidence rates were higher in men (0.79/100,000) than in women (0.40/100,000). Between the periods 1982-1991 and 2002-2011, it decreased from 0.97 to 0.53 per 100,000 in men and from 0.44 to 0.30 per 100,000 in women. Overall, 19 % of the tumors were limited to the mucosa, 69 % to the submucosa, and 15 % invaded lymph nodes. Node invasion and male sex were the only significant prognostic factors. Five-year net survival was 50 % in node-positive patients and 85 % in node-negative patients (p < 0.001). In multivariate analysis, the relative risk of death in men compared to women was 2.3 and was 10.4 in patients with positive nodes compared to patients with negative nodes. CONCLUSIONS: EGCs are rare in France. The prognosis is favorable, except for node-positive cancers, which may benefit from the recently developed adjuvant chemotherapy for gastric cancer.
BACKGROUND: Little is known about the epidemiology of early gastric cancer (EGC) in Western countries. The aim of this study was to analyze trends in the incidence, management, and survival of EGC in a well-defined population over a 30 year period. METHODS: Data were obtained from the population-based cancer Registry of Burgundy (France). Incidence rates were calculated by sex, age, and 10 year period of diagnosis. Net survival rates were calculated and a multivariate relative survival analysis performed. RESULTS:EGC represented 6.7 % of gastric cancer diagnosed between 1982 and 2011. Age-standardized incidence rates were higher in men (0.79/100,000) than in women (0.40/100,000). Between the periods 1982-1991 and 2002-2011, it decreased from 0.97 to 0.53 per 100,000 in men and from 0.44 to 0.30 per 100,000 in women. Overall, 19 % of the tumors were limited to the mucosa, 69 % to the submucosa, and 15 % invaded lymph nodes. Node invasion and male sex were the only significant prognostic factors. Five-year net survival was 50 % in node-positive patients and 85 % in node-negative patients (p < 0.001). In multivariate analysis, the relative risk of death in men compared to women was 2.3 and was 10.4 in patients with positive nodes compared to patients with negative nodes. CONCLUSIONS:EGCs are rare in France. The prognosis is favorable, except for node-positive cancers, which may benefit from the recently developed adjuvant chemotherapy for gastric cancer.
Authors: Nicolas Chapelle; Nicolas Musquer; Elodie Métivier-Cesbron; Dominique Luet; Christelle Volteau; Marc Le Rhun; Emmanuel Coron Journal: United European Gastroenterol J Date: 2018-07-10 Impact factor: 4.623