Gastric Adenocarcinoma Treatment in Africa: Surgery Alone or Perioperative Chemotherapy?

Aim: Evaluate the impact of MAGIC trial on gastric adenocarcinoma’s managementin Africa. Method and methodology: It was about a review of literatureon therapeutic aspects of gastric adenocarcinoma in the African area.We have taken a census of 21 articles including 2792 patients published between1980 and 2013. We have distinguished articles published before 2006(group 1) from those published after 2006 (group 2) to better understand therapeuticchanges after that perioperative chemotherapy has become a standardin gastric adenocarcinoma’s management. Results: Surgery remains inAfrica 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 the2nd group underwent surgical procedures. Perioperative chemotherapy takeslonger to be part of therapeutic habits (0.18%). Factors related to patients suchalteration of general state with a WHO performance status superior to 2 in72% of cases, the lack of financial accessibility to anticancerous drugs explainspartly the non-use of perioperative chemotherapy. This is also due to factorspeculiar to our sanitation structures which don’t have enough cancer specialists.So we noticed that MAGIC trial is simply ignored in certain studies. Thelack of adoption of perioperative chemotherapy explains with delayed diagnosisthe low survival of patients in the African area. Conclusion: MAGIC trialpractically has no effect on therapeutic behavior yet comparatively to gastricadenocarcinoma in Africa. The insurance particularly relies on surgery onlyuntil now. However, it might enable us to improve gastric adenocarcinoma’ssurvival rates.