[Carcinoma of the stomach. Resectability and survival rates in 408 operated patients (author's transl)].

In 125 cases (30,6%) the tumour could not be removed, mainly because of peritoneal metastases and posterior extra-gastric extension. Tumoral resection was performed in 283 cases (69.4%), being palliative in 76 and considered as curative in 216 (52.9%). There were 177 distal gastrectomies, 40 proximal and 66 total gastrectomies with oesophageal resection adapted to the extent of the tumour. Operative mortality was 2.1% after resection and 8% after exploratory and derivative surgery. The five-year survival rates among 213 patients operated upon before December 1973, were 50.8% after curative resection, 39% for all resections and 27.7% for all patients who underwent surgery. The long-term prognosis was evaluated in relation to the site of the lesion, its depth of penetration into the gastric wall and its extension to the lymph nodes. Spreading superficial carcinomas had a five-year survival rate of 89.6% and their incidence (14% of all operated patients) did not change in recent years despite the increasing use of gastric endoscopy. Extension to the lymph nodes was a very important prognostic factor, since the five-year survival rate was 75% in patients with non-invaded primary lymph nodes, as opposed to 32% in patients with invaded primary lymph nodes and only 5% in patients with secondary node involvement.