To study the spectrum of Gastrointestinal and Hepato-Pancreato-Biliary Tract Malignancies at a Tertiary Centre in South India.

AIM AND OBJECTIVE : To study the spectrum of gastrointestinal and hepato-pancreato-biliary tract malignancies at a tertiary centre in south India and to analyse the clinico-pathological profile. MATERIAL AND METHODS : All patients from departments of Gastroenterology and Hepatology newly diagnosed with a gastrointestinal (GI) or hepato-pancreato-biliary (HPB) tract malignancy from August 2013 to December 2014 were enrolled after an informed consent. The diagnosis was based on the histopathological report of endoscopic biopsies in case of GI cancers. A combination of radiological findings, laboratory markers and if available, histopathology were used to diagnose HPB malignancies. Data collected for analysis included clinical presentation, age, site of involvement, life-style factors, socio-economic status and histological types were available. RESULTS : Of 1200 patients, median age was 53 years (14 to 89) and male:female ratio 2.3:1. Most common malignancies were stomach (25%), colorectal (19 %), esophagus (18 %) and HCC (17 %). 58% were seen in fourth-sixth decade of life. Esophageal carcinoma was located mainly in lower (30%) and mid esophagus (26%), mostly squamous-cell carcinoma (69%). 92% of gastric malignancies were localised distally. Rectum (51%) was the most common colorectal malignancy. For HCC, most common etiologies were HBV (37%). Only 32% met a curative strategy at presentation. Most pancreato-biliary malignancies presented in an advanced stage except periampullary where 73% were operable. CONCLUSIONS : While gastric and oesophageal malignancies continue to remain common GI malignancies, rectal and liver carcinomas appear to show an increased incidence. HPB malignancies continue to present at an advanced stage in the majority