Adenocarcinoma of the stomach: A review of 35 years and 1,710 cases

• Published in: World journal of surgery 1990-09, Vol.14 (5), p.580-586
• Main Authors: Breaux, John R., Bringaze, Walter, Chappuis, Charles, Cohn, Isidore
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - epidemiology; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Cancer Gastrique; Charity Hospital; Female; Gastric Cancer; Humans; Incidence; Louisiana - epidemiology; Male; Middle Aged; Radical Subtotal Gastrectomy; Retrospective Studies; Sex Factors; Stomach Neoplasms - epidemiology; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Subtotal Gastrectomy; Survival Rate
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/BF01658794

The records of 1,710 patients with adenocarcinoma of the stomach treated at Charity Hospital over a 35‐year period were reviewed to note any trends which might help in understanding the decreasing incidence and poor prognosis of the disease. The yearly number of gastric cancer patients has dropped from 234/100,000 in the 1950's to 195/100,000 in the 1960's to 108/100,000 patients in the last decade. The percentage of affected white males is decreasing at a rate equal to the increasing frequency of black female patients, while the ratios for black males and white females remain constant. The median age rose from 61.5 years to 66 years over the study period. The operability rate decreased from 82.4% to 72.8% and the resectability rate was 49%. Subtotal gastrectomy was the most common procedure, but radical subtotal gastrectomy gave the best 5‐year survival. There are fewer lesions of the antrum today, but the highest number of 5‐year survivors had antral lesions. Long‐term survival of patients with lesions of the cardia improved from zero in the first 25 years to 14% in the last decade. For the last 2 decades, patients with stage III and IV lesions comprised one‐half of the 5‐year survivors. Our overall 5‐year survival was 7.9%, but in the last decade it was 8.9%. Our 5‐year survival for all patients who underwent a resection was 17.9%, but increased to 24.8% for the last decade. These improvements, in combination with a decrease in incidence, have dropped the overall mortality from gastric cancer. Résumé Les dossiers de 1,710 patients ayant eu un adénocarcinome de l'estomac traités au cours des dernières années à l'Hôpital de la Charité (Nouvelle Orléans) ont été revus pour chercher des indices qui pourraient permettre de comprendre l'incidence décroissante et le mauvais pronostic de cette maladie. Le nombre de cancer gastrique par an est passé de 234/ 100,000 dans les années 50 à 195/100,000 dans les années 60 et à 108/100,000 dans la dernière décennie. Le pourcentage d'hommes de race blanche décroît, celui des femmes de race noire augmente, ceux des hommes de race noire et des femmes de race blanche restent stationnaires. L'âge médian a augmenté de 61.5 à 66 ans pendant la période d'étude. Le taux d'opérabilité a baissé de 82.4% à 72.8%, le taux de résectabilité était de 49%. La gastrectomie subtotale était pratiquée le plus souvent; la gastrectomie subtotale radical a donné la meilleure survie à 5 ans. Le nombre global de lésions antrales a diminué, mais