Surgical Treatment of Gastric Carcinoma

Abstract

A series of 2,590 gastric carcinoma patients were studied in Finland over a 27-year period, divided into three time periods. The proportion of patients not operated on dropped from 46% in period 1 to 20.7% in period 3. The proportion of patients receiving total or proximal gastrectomy rose from 0.9% to 23%. Resectability rose from 21,1% in period 1 to 45.1% in period 3, the most distinct improvement being noted in carcinoma of the cardia. The operative mortality of proximal or total gastrectomy was about 16%; for distal gastrectomy for cure, 4.8%. Five-year survival for curative subtotal gastrectomy rose from 23% in period 1 to 43% in period 3; for proximal or total gastrectomy, from 0 (only 9 were done in that period) to 30%. Despite the higher primary mortality, carcinoma of the cardia has a prognosis as good as that for carcinoma of the antrum.