title: Trends in clinical features, postoperative outcomes, and long-term survival for gastric cancer: a Western experience with 1,278 patients over 30 years.
abstract: BACKGROUND
  The aim of the present study was to identify temporal trends in long-term survival and postoperative outcomes and to analyze prognostic factors influencing the prognosis of patients with gastric cancer (GC) treated in a 30-year interval in a tertiary referral Western institution.
  
  
  METHODS
  Between January 1980 and December 2010, 1,278 patients who were diagnosed with GC at the Digestive Surgery Department, Catholic University of Rome, Italy, were identified. Among them, 936 patients underwent surgical resection and were included in the analysis.
  
  
  RESULTS
  Over time there was a significant improvement in postoperative outcomes. Morbidity and mortality rates decreased to 19.4% and 1.6%, respectively, in the last decade. By contrast, the multivisceral resection rate steadily increased from 12.7% to 29.6%. The overall five-year survival rate steadily increased over time, reaching 51% in the last decade, and 64.5% for R0 resections. Multivariate analysis showed a higher probability of overall survival for early stages (I and II), extended lymphadenectomy, and R0 resections.
  
  
  CONCLUSIONS
  Over three decades there was a significant improvement in perioperative and postoperative care and a steady increase in overall survival.
authors.affiliation: Department of Digestive Surgery, Catholic University, "A, Gemelli" Hospital, Largo A, Gemelli, 8, Rome 00168, Italy. faust.rosa@tiscali.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Rosa
authors.forename: Sergio
authors.initials: S
authors.lastname: Alfieri
authors.forename: Antonio Pio
authors.initials: AP
authors.lastname: Tortorelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiorillo
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Doglietto
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008297:Male; D009017:Morbidity; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D062606:Tertiary Care Centers