Epidemiology and long term survival of gastric carcinoma in the French district of Finistere between 1984 and 1995.
OBJECTIVE
The aims of this study were to evaluate trends in incidence, clinical characteristics, treatment regimen and prognosis of gastric carcinoma in the area of Finistere (France) during a 12-year period.


METHODS
Between 1984 and 1995, the Finistere Registry of GastroIntestinal Tract Tumors listed 2 139 patients with gastric carcinoma in a population of 838 627 inhabitants. Curative resection and operative mortality were analyzed by logistic regression. Prognostic factors were determined using the Kaplan-Meier method and the Cox model.


RESULTS
When comparing the second period (1990-1995) to the first period (1984-1989) we observed: a) a decrease of standardized incidence (13.2 vs. 15.6/100 000 inhabitants/year in males and 5.4 vs. 7.0/100 000 inhabitants/year in females); b) a significant increase of linitis plastica (21.4% vs. 10.9%) and infiltrative tumors (53.1 vs. 31.2%) (P<0.0001); c) no variation in tumor stage at diagnosis; d) a significant increase in curative resection (65.7% vs. 45.0%; P<0.0001); e) no variation in operative mortality; f) the absence of improvement of survival rate; the latter was 29% at 2 years, 19% at 5 years and 11% at 10 years during the second period. Multivariate analysis showed that the main prognostic factors of gastric carcinoma were age, tumor stage and the type of surgical procedure.


CONCLUSIONS
This study showed a decrease in the incidence of gastric carcinoma over time and an increase of linitis plasticia and infiltrative forms. Despite improvement in management of patients, the global prognosis of gastric carcinoma did not improve significantly over a 12-year period of observation.
Fayçal
Joseph
J
Service d'Hépato-Gastroentérologie, CHU La Cavale Blanche, 29609 Brest Cedex, France. jo29@voila.fr
Bessaguet
Christophe
C
Nousbaum
Jean-Baptiste
JB
Cauvin
Jean-Michel
JM
Cholet
Franck
F
Bideau
Karine
K
Robaszkiewicz
Michel
M
Gouérou
Hervé
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors