Gastric cancer: a curable disease in Britain.
OBJECTIVE
To determine whether more vigorous efforts aimed at earlier diagnosis allied to radical surgical resection lead to improved survival of patients with gastric cancer.


METHODS
Prospective audit of all cases of gastric cancer treated during 1970-89.


METHODS
Department of surgery, general hospital.


METHODS
493 consecutive patients with gastric adenocarcinoma.


METHODS
Operative mortality, postoperative morbidity, and five year survival after radical potentially curative resection.


RESULTS
207 (42%) patients underwent potentially curative resection. The proportion of all patients in whom this was possible increased significantly (p < 0.01) from 31% in the first five year period to 53% in the last five year period. The proportion of patients who had early gastric cancer rose from 1% to 15% (p < 0.01) and stage I disease rose from 4% to 26% (p < 0.001). After potentially curative resection, mortality 30 days after operation was 6%. Operative mortality decreased from 9% in the 1970s to 5% in the 1980s. Likewise, the incidence of serious postoperative complications decreased from 33% in the 1970s to 17% in the 1980s (p < 0.01). Five year survival was 60% in patients who underwent curative resection, 98% in patients with early gastric cancer, and 93%, 69%, and 28% in stage I, II, and III disease respectively. By the late 1980s five year survival after operation was about 70%.


CONCLUSIONS
These findings suggest that an increasing proportion of patients with gastric cancer could be diagnosed at a relatively early pathological stage when about two thirds are curable by means of radical surgery.
Sue-Ling
H M
HM
Academic Unit of Surgery, Centre for Digestive Diseases, General Infirmary, Leeds.
Johnston
D
D
Martin
I G
IG
Dixon
M F
MF
Lansdown
M R
MR
McMahon
M J
MJ
Axon
A T
AT
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D013270:Stomach / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors