Clinico-pathological presentation of gastric carcinoma and its relation to the anatomical site of occurrence among patients in the hilly state of Himachal Pradesh, India


  • Amar Chand Department of Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Parikshit Malhotra Department of Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Deepesh Barall Department of Community Medicine, Dr YSPG Medical College, Nahan, Himachal Pradesh, India
  • Sudhir Singh Department of Health and Family Welfare, District Kinnaur at Reckong Peo, Himachal Pradesh, India
  • Garima Thapa Department of Pathology, Dr RPGMCH, Tanda, Himachal Pradesh, India



Clinical and pathological presentation, Gastric carcinoma, Relation of signs and symptoms with site of occurrence


Background: The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. Himachal Pradesh, located in the north of India, has different customs, food habits, life-style and diverse ethnic groups. We undertook this study to analyze the clinical presentations and pathological characteristics of stomach cancer patients in the biggest referral center in the state.

Methods: All endoscopic biopsy proven cases of carcinoma stomach attending the OPD or admitted in the general surgery ward between July 2014 to June 2015, went through a thorough clinical examination, routine and diagnostic investigations and endoscopic biopsies for histopathological confirmation.

Results: The study included 62 patients of adenocarcinoma stomach with maximum cases between 45 to 65 yrs age, more in males (2:1). Borrmann type II was most common macrocsopic appearance followed by type IV. As per Lauren classification, 36 were of intestinal, 24 diffuse and 2 had mixed type. 10 patients had well differentiated, 28 moderately differentiated and 24 patients had poorly differentiated tumors. Anorexia, abdominal pain, weight loss, nausea and vomiting was the most common symptoms seen in antral lesions (distal) and anemia was the most common sign followed by dehydration, mass abdomen and ascitis.

Conclusions: The study has added to the literature of clinical and pathological presentation and relation of signs and symptoms to the site of occurrence of gastric carcinoma from the hilly and rural state of northern India.



Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57(1):43-66.

Rao DN, Ganesh B. Estimate of cancer incidence in India in 1991. Indian J Cancer. 1998;35(1):10-8.

Hirohata T, Kono S. Diet/nutrition and stomach cancer in Japan. Int J Cancer. 1997;10:34-6.

Gajalakshmi V, Swaminathan R, Shanta V. An independent survey to assess completeness of registration: population based cancer registry, Chennai, India. Asian Pac J Cancer Prev. 2001;2(3):179-83.

Sen U, Sankaranarayanan R, Mandal S, Ramanakumar AV, Parkin DM, Siddiqui M. Cancer patterns in eastern India: the first report of the Kolkata cancer registry. Int J Cancer. 2002;100(1):86-91.

Sumathi B, Ramalingam S, Navaneethan U, Jayanthi V. Risk factors for gastric cancer in South India. Singapore Med J. 2009;50(2):147-51.

Cherian JV, Sivaraman R, Muthusamy AK, Venkataraman J. Stomach carcinoma in the Indian subcontinent: A 16-year trend. Saudi J Gastroenterol. 2007;13(3):114-7.

Barad AK, Mandal SK, Harsha HS, Sharma BM, Singh TS. Gastric cancer-a clinicopathological study in a tertiary care centre of North-eastern India. J Gastrointest Oncol. 2014;5(2):142-7.

Nakamura T, Yao T, Niho Y, Tsuneyoshi M. A clinicopathological study in young patients with gastric carcinoma. J Surg Oncol. 1999;71(4):214-9.

Safaee A, Moghimi-Dehkordi B, Fatemi SR , Ghiasi S, Pourhoseingholi MA, Zali MR. Clinicopathological features of gastric cancer: a study based on cancer registry data. IJCP. 2009;2:67-70.

Wang Z, Liu L, Ji J, Zhang J, Yan M, Zhang J, et al. ABO Blood Group System and Gastric Cancer: A Case-Control Study and Meta-Analysis. Int J Mol Sci. 2012;13(10):13308-21.

Sussman SK, Halvorsen RA Jr, Illescas FF, Cohan RH, Saeed M, Silverman PM, et al. Gastric adenocarcinoma: CT versus surgical staging. Radiol. 1988;167(2):335-40.






Original Research Articles