Adenocarcinoma of the stomach: are we making any progress?

We studied 2,062 patients with adenocarcinoma of the stomach seen at The University of Texas M. D. Anderson Hospital and Tumor Institute between 1944 and 1984. The distribution by site was cardia 33%, antrum 31%, and body 27%; 9% of the patients had linitis plastica. The raw five-year survival rate was 12.5%; surgically treated patients with negative nodes had a five-year survival rate of 75%, compared to 19% for those with positive nodes. Forty-one percent of patients had diagnostic procedures only, 35% had a Billroth I or II gastrectomy, and 24% had total gastrectomy or radical proximal gastrectomy. In the first decade fewer than one new patient per week was registered, but this has increased to more than two during the last decade. This apparent increase is due to the 65% of patients referred for palliative chemotherapy. Improved nutritional support has made operations safer and combined with chemotherapy has provided modest progress.