Factors influencing prognosis in gastric cancer.

In a group of 322 patients with adenocarcinoma of the stomach, 158 underwent resection. The only 5 year survivors came from the resection group. Increasing age, lymph node metastases and increasing depth of invasion of the gastric wall were all adverse prognostic features. There was a high incidence (19%) of resected patients who had suture line involvement. In spite of this there were 5 year survivors among those patients with suture line involvement and also those with lymph node involvement. The judicious implementation of an aggressive resection policy will give patients with favourable tumours the chance of a 5 year cure without involving patients with widespread neoplasm in radical surgery. Patients who had undergone previous gastric surgery for any cause had an extremely bad prognosis. Improvement in 5 year survival rates in patients undergoing resection for gastric cancer could be attributed to the increase in the number of patients with early gastric cancer.