Surgical management of gastric adenocarcinoma.

This paper has analyzed the results of surgical management of 196 patients with gastric carcinoma treated from 1958 through 1982 at the Brigham and Women's Hospital in Boston and compares the experience during this time period with that of the previous 45 years. Surgical technique, operative mortality and complications, and 5 year survival were recorded. The resectability rate of the tumor in patients explored was 78.1 percent, and the 5 year survival rate for all 153 gastrectomies was 24.9 percent (36.2 percent for curative gastrectomy and 8.6 percent for palliative gastrectomy). Chronologic comparison over the years showed a decrease in the incidence of cancer of the stomach over the past 65 years, a steady increase in the 5 year absolute survival of patients with gastric carcinoma, and a significant decrease in the operative mortality and an increase in the 5 year survival after subtotal gastrectomy.