Gastric Adenocarcinoma Treatment in Africa: Surgery Alone or Perioperative Chemotherapy?
2017
Aim: Evaluate the impact of MAGIC trial on gastric adenocarcinoma’s management
in Africa. Method and methodology: It was about a review of literature
on therapeutic aspects of gastric adenocarcinoma in the African area.
We have taken a census of 21 articles including 2792 patients published between
1980 and 2013. We have distinguished articles published before 2006
(group 1) from those published after 2006 (group 2) to better understand therapeutic
changes after that perioperative chemotherapy has become a standard
in gastric adenocarcinoma’s management. Results: Surgery remains in
Africa the first and practically the only treatment weapon in gastric adenocarcinoma:
46% to 92% people in the 1st group and 65% to 100% people in the
2nd group underwent surgical procedures. Perioperative chemotherapy takes
longer to be part of therapeutic habits (0.18%). Factors related to patients such
alteration of general state with a WHO performance status superior to 2 in
72% of cases, the lack of financial accessibility to anticancerous drugs explains
partly the non-use of perioperative chemotherapy. This is also due to factors
peculiar to our sanitation structures which don’t have enough cancer specialists.
So we noticed that MAGIC trial is simply ignored in certain studies. The
lack of adoption of perioperative chemotherapy explains with delayed diagnosis
the low survival of patients in the African area. Conclusion: MAGIC trial
practically has no effect on therapeutic behavior yet comparatively to gastric
adenocarcinoma in Africa. The insurance particularly relies on surgery only
until now. However, it might enable us to improve gastric adenocarcinoma’s
survival rates.
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