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

Authors

  • Caspar Franck Deptartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany
  • Nadja Zimmermann Deptartment of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany
  • Elisabetta Goni Department of Internal Medicine II, Ludwig Maximilians University Hospital, Munich, Germany
  • Hans Lippert Department of General, Visceral, Vascular and Transplantation Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany
  • Karsten Ridwelski Department of Surgery, Municipal Hospital, Magdeburg, Germany
  • Martin Kruschewski Department for General, Visceral und Thoracic surgery, Frankfurt (Oder) Municipal Hospital, Frankfurt (Oder), Germany
  • Nicole Kreuser Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
  • Philipp Lingohr Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
  • Claus Schildberg Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
  • Nikolaos Vassos Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, Mannheim University Medical Center, University Heidelberg, Mannheim, Germany
  • Oliver Waidmann Department of Gastroenterology and Hepatology, University Hospital of Frankfurt a. Main, Frankfurt, Germany
  • Ulrich Peitz Department of Gastroenterology, Raphaelsklinik Muenster, Muenster, Germany
  • Hauke Lang Department of Gastroenterology, Raphaelsklinik Muenster, Muenster, Germany
  • Peter P Grmminger Department of Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
  • Christiane Bruns Deparment of General, Visceral, Tumor and Transplantation Surgery, University Hospital Cologne, Cologne, Germany
  • Lothar Veits Institute of Pathology, University of Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
  • Michael Vieth Institute of Pathology, University of Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
  • Markus Moehler First Medical Clinic and Policlinic, University Medical Center of Johannes Gutenberg-University Mainz, Mainz, Germany
  • Florian Lordick Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
  • Ines Gockel Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
  • Johannes Schumacher Center for Human Genetics, Philipps University Marburg, Marburg, Germany
  • Peter Malfertheiner 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
  • Marino Venerito Magdeburg, Germany

DOI:

https://doi.org/10.15403/jgld-3795

Keywords:

gastric cancer, cardia gastric cancer, non-cardia gastric cancer, stomach neoplasms, cardia, cohort study, weight loss, deglutition disorders

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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Published

2021-12-21

How to Cite

1.
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. JGLD [Internet]. 2021 Dec. 21 [cited 2026 Jul. 10];30(4):431-7. Available from: https://www.jgld.ro/jgld/index.php/jgld/article/view/3795

Issue

Vol. 30 No. 4: December 2021

Section

Original Article