title: Experience of 463 cases of gastric cancer from a single surgical center.
abstract: OBJECTIVE
  To evaluate clinical and histopathological changes of gastric cancer (GC) in the last fifteen years and analyze factors influencing overall survival.
  
  
  METHODS
  We have retrospectively categorized patients submitted to surgery for GC from January 1996 to December 2010. The analysis focused on two periods: 1996-2003 (period 1) and 2004-2010 (period 2).
  
  
  RESULTS
  There was an increase in age distribution of GC in period 2 (p=0.012). Significant increase of whole GC was observed in period 2 (p=0.01). Slight but significant changes in TNM stage were found: in group 2 there was a decrease in the rate of early GC and in advanced depth of tumor invasion; increase of lymph nodes involvement was also demonstrated. Overall survival (OS) had not changed from the first to the second period. There was a significant difference in OS calculated for Lauren histotype: from ten months to surgery, patients with diffuse histotype showed worse prognosis.
  
  
  CONCLUSIONS
  The most important findings were an increase in lymph node involvement and a decrease in depth of tumor invasion, an higher percentage of whole type and a decrease in palliative surgery. Overall-survival hasn't change in the last fifteen years. These results confirms the importance of extent of lymph node dissection in the standard surgical approach of GC, the tumor stage and Lauren histotypes as the main prognostic factors in GC.
  
  
  CONCLUSIONS
  This work confirms the dismal prognosis of GC and the need to increase diagnosis of early gastric cancer.
  
  
  BACKGROUND
  Gastric cancer, Lauren histotype, Overall survivall.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Viani
authors.forename: Elisa
authors.initials: E
authors.lastname: Bertocchi
authors.forename: Gioacchino Giovanni
authors.initials: GG
authors.lastname: Iapichino
authors.forename: Paolo
authors.initials: P
authors.lastname: Dell'Abate
authors.forename: Roberto
authors.initials: R
authors.lastname: Sivelli
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000556:secondary / Q000601:surgery; D017677:Age Distribution; D055088:Early Detection of Cancer; D005743:Gastrectomy / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010166:Palliative Care / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis