Gastric carcinoma: review of the results of treatment in a community teaching hospital.

BACKGROUND

The aim of this study is to provide data on long term results of gastric cancer surgery and in particular the D1 gastric resection.

METHODS

In the period 1992-2004, 235 male and female patients with a median age of 69 and 70 years respectively, were included with a stage I through IV gastric carcinoma, of which 37% was stage IV disease. Whenever possible a gastric resection was performed. In case of obstructive tumour growth palliation was provided by means of a gastro-enterostomy.

RESULTS

Gastrectomy with curative intent was achieved in 50%, palliative resection in 22%, palliative surgery (gastro-enterostomy) in 10% and in 18% irresectability led to surgical exploration only. Patients in the curative intent group demonstrated a 47% survival after 5 years and up to 34% after 10 years. However metastases where seen in 32% of the patients after gastrectomy with curative intent. After palliative resection one year survival was 57%, whereas 19% survived more than 3 years. Overall postoperative morbidity and mortality rates were 40% and 13% respectively.

CONCLUSION

Long term survival after surgery for gastric cancer is poor and is improved by early detection and radical resection. However, palliative resection showed improved survival compared to gastro-enterostomy alone or no resection at all which may be an effect of adjuvant therapy.