[Stomach cancer: 10 years experiences with surgical treatment and possibilities for improving the prognosis].
We retrospectively evaluated data on 111 consecutive patients operated between 1976 and 1985 for gastric carcinoma. Patients were staged according to the TNM classification (stage I - 17%, II - 15%, III - 30%, IV - 37%). 66 patients (59.5%) underwent radical resection. Most of curative resections were subtotal distal gastrectomies. Extended lymphadenectomy was not performed. The operative mortality rate was 7.4% in case of curative resections, and 9.6% overall. 20 out of 66 radically operated patients (30%) were treated with adjuvant cytotoxic chemotherapy, while 9 out of 45 non radically operated patients were treated with palliative cytotoxic chemotherapy. The median follow-up time was 36 months (range: 1-166 months) for patients operated for cure and 25 months for the whole population. The estimated adjusted 5-year survival rate was 41.3% after operation in a curative intent, 82.9% for stage I, 62.8% for stage II, 17.8% for stage III, 3.3% for stage IV. The duration of symptoms before diagnosis was longer than 6 months in 18 patients (16.2%) and longer than 10 months in 9 patients (8.1%). Patients who were symptomatic since more than 10 months were on the average about 10 years younger than the rest of the population. The median duration of symptoms was 3.2 months overall, but reached 7.1 months in patients less than 40 years old. Patients with an early gastric cancer (11/111: 9.9%) or stage I disease (19/111: 17.1%) had always symptoms since less than 5 months. The proportion of early gastric cancer increased from 6.3% (3/48) to 12.7% (8/63) from 1976-1980 to 1981-1985, simultaneously to the diffusion of the upper gastrointestinal endoscopy.(ABSTRACT TRUNCATED AT 250 WORDS)
Spataro
V
V
Service de chirurgie, Ospedale S. Giovanni, Bellinzona.
Genoni
M
M
Maurer
C
C
Müller
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
Carcinome gastrique: expérience de 10 ans de traitement chirurgical et possibilités d'amélioration pronostique.