[Epidemiology and prognosis of gastric carcinomas at the province of Calvados. A 10-year study].

OBJECTIVES

The aim of this study was to determine trends in incidence and survival for gastric cancer in the department of Calvados over a ten-year period.

METHODS

Between 1978 and 1987, 999 patients with gastric cancer were registered by the Registry of digestive tumours of Calvados. Standardized incidence rates were calculated for males and females and for each site of the tumour in two consecutive 5-year periods: period I: 1978-1982; period II: 1983-1987. Then prognostic factors were determined with univariate and multivariate methods.

RESULTS

Global incidence rates were 15.7/100,000 in men, and 6.7/100,000 in women. Incidence rates of antropyloric carcinomas significantly decreased in women (period I: 3.6/100,000, period II: 2.1/100,000; P < 0.01). The incidence rate of cancer of the cardia did not change in men (period I: 2.7/100,000, period II: 2.9/100,000; NS) nor in women (period I: 0.6/100,000, period II: 0.3/100,000; NS). The ratio of early gastric cancer was respectively 8% and 9.2% (NS). The frequency of "signet ring" cells carcinomas increased from 20% during period I, to 34% during period II (P < 0.05). Overall 5-year survival rate was 16%; it was 26.3% after resection, without significant change between the two periods (27% versus 24.4%). The multivariate study in gastric cancer after resection pointed out 5 prognostic factors: age over 75 years, invaded resection margins, lymph node involvement, metastases and parietal wall involvement.

CONCLUSIONS

The results of this epidemiologic study in the department of Calvados indicate that a) the global prognosis of gastric cancer was poor and did not change over the 10 years of the study; b) incidence rates of antropyloric carcinomas slightly decreased in women; c) rates of early gastric cancers did not increase.