Correlation between Clinical Presentation and Operative Feasibility in Patients with Gastric Carcinoma: A Study from a Tertiary-Level Hospital

Introduction: Gastric carcinoma remains a significant cause of morbidity and mortality in developing countries, often diagnosed at an advanced stage. This study aimed to evaluate the correlation between clinical presentation and operative feasibility in patients with gastric carcinoma admitted to a tertiary-level hospital. Methods: This cross-sectional study was conducted in the Department of Surgery, Bangladesh Medical College Hospital, Dhaka, Bangladesh, from August 2011 to June 2012. In this study, a total of 52 patients with histologically confirmed gastric carcinoma who were admitted to the surgical department of BMCH for operative treatment were included. Demographic data, clinical features, blood group distribution, addiction history, diagnostic findings, and operative outcomes were analyzed. Result: Most patients (63%) were aged between 40 and 60 years, with a male predominance (71%; male-to-female ratio 2.47:1). Blood group A was the most common (62%). Nearly half of the patients were smokers (54%), and 29% used tobacco in other forms. Common clinical symptoms included pallor/fatigue (69%), epigastric pain or lump (35%), and weight loss (38%). Physical findings showed epigastric tenderness or mass (35%), anemia (46%), and lymphadenopathy (12%). Endoscopic examination revealed mitotic lesions predominantly in the antrum and pylorus (62%). Histopathology showed that 48% of tumors were well-differentiated adenocarcinomas. Among 52 patients, 46 underwent surgery: 24 were operable, 22 underwent palliative procedures, and 6 (12%) were deemed inoperable and unfit for surgery. Advanced disease findings included regional lymph node involvement (65%), fixed posterior abdominal wall growth (42%), and peritoneal seeding (19%). Conclusion: This study showed that gastric carcinoma continues to present at an advanced stage in Bangladesh, often limiting curative surgical options. Early diagnosis and intervention remain essential to improving operability and patient outcom