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IN-HOSPITAL DIAGNOSIS OF GASTRIC ADENOCARCINOMA IS ASSOCIATED WITH HIGHER STAGE CANCER
Julie Hong
2, Oscar Champigneulle
*1, Jian Zheng
2, Jini Hyun
2, Pierre F. Saldinger
21College of Medicine, SUNY Downstate Health Sciences University, New York City, NY; 2NewYork-Presbyterian Queens, Flushing, NY
Introduction:
There are no standard screening guidelines to advocate for early diagnosis of gastric cancer and treatment among the general population in the United States. Our community has a high prevalence of gastric cancer. This study aims to investigate the differences and consequences between patients who presented with gastric cancer in an inpatient versus outpatient setting.
Methods:
This is a single-institution, retrospective cohort study including all adult patients diagnosed with gastric adenocarcinoma between 2016-2023 with subsequent surgery. We excluded patients who had gastroesophageal junction cancers and those who did not undergo surgery after diagnosis.
Results:
Patients diagnosed with gastric cancer in the outpatient setting (n=123) were compared with those diagnosed in the inpatient setting (n=29). Inpatient diagnosis was associated with higher pathological TNM stage 2 to 4 (45% vs 22% among outpatients, p=0.002), non-curative surgery (24% vs. 2.4%, p=0.001), lymphovascular invasion on pathology (34% vs. 15%, p=0.005), and increased 90-day postoperative complications (34% vs. 21%, p=0.048). Compared to Asian patients, patients of non-Asian descent were more likely to be diagnosed inpatient rather than outpatient (38% vs 16%, p=0.009).
Conclusions:
Gastric cancer is associated with more advanced cancer and worse outcomes when diagnosed in the inpatient setting. Patients receiving inpatient diagnoses of gastric cancer are older, non-Asian patients, with more advanced cancer. Increasing awareness and implementing screening protocols for high-risk populations could lead to improved outcomes in patients with gastric cancer.
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