Surgical management of gastric carcinoma. Follow-up results in 465 consecutive cases.

A retrospective study was made of a consecutive series of 465 patients with histologically proven gastric carcinoma operated on from December 1950 to December 1974. There were 352 men and 113 women, for a male-female ratio of 3.1 to 1. The peak age of incidence was 51 to 55 years. Noncurative surgical procedures were performed in 49.5 percent with no 5 year survivors; 50.5 percent had curative gastric resection. The ulcerating type was the most common lesion, and the pylorus and antrum were the most common primary sites of tumor. Applying the TNM pathologic stage grouping, the study revealed that 3.4 percent of the patients with curative resections were in stage I, 25.5 percent were in stage II and 71 percent in stage III. The 5 year survival rate was 100 percent for stage I, 70 percent for stage II and 20 percent for stage III. Eighty-four patients or 35.7 percent of those with curative gastric resection survived 5 years or longer. The operative mortality was 3.5 percent for the group with noncurative surgical procedures and 2.1 percent for the group with curative gastric resections, giving an overall operative mortality of 2.8 percent for the entire series.