title: Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study.
abstract: BACKGROUND
  Although gastric cancer has been decreasing in incidence in many countries, it is still the second most common cause of cancer deaths worldwide. Its prognosis is poor and depends, among other factors, on early diagnosis as well as on surgeon expertise.
  
  
  OBJECTIVE
  To compare the outcomes of gastric cancer patients treated at a university hospital by a general surgical team and later on by a gastric cancer surgical team.
  
  
  METHODS
  Gastric cancer patients were separated into two groups according to whether they were treated by a general surgical team (group 1, n = 136; 1984 to 1993) or by gastric cancer team (group 2, n = 149; 1994 to 2003). Clinical and pathologic features and survival rates were assessed.
  
  
  RESULTS
  During a 20-year period, a decreased number of patients underwent surgical resection in the second period (94% vs 86%), a greater number of upper gastrointestinal endoscopies were performed resulting in an increased number of tumors diagnosed as stage I (5% vs 22%). Also, D2 gastrectomies were more frequently performed instead of D0 gastrectomies and negative surgical margins were adequate. Mortality decreased from 9% to 6% in group 1 and 2, respectively and adjuvant therapy has been considered.
  
  
  CONCLUSIONS
  Surgical specialized units for gastric cancer are necessary if better results are to be expected since this approach definitely provides better patient care.
authors.affiliation: Surgical Unit of the Stomach and Small Intestine, University Hospital, Federal University of Santa Maria, RS, Brazil.
authors.forename: Fernando O
authors.initials: FO
authors.lastname: Souza
authors.forename: Dalnei V
authors.initials: DV
authors.lastname: Pereira
authors.forename: Luís H
authors.initials: LH
authors.lastname: Santos
authors.forename: Luis
authors.initials: L
authors.lastname: Antunes
authors.forename: Juarez
authors.initials: J
authors.lastname: Chiesa
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D013502:General Surgery; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013043:Specialties, Surgical / Q000706:statistics & numerical data*; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome