Open AccessCarcinoma of the Stomach. Why Are We Failing to Improve Survival?
Author(s) -
Thomas E. Weed,
William R. Nuessle,
Alton Ochsner
Publication year - 1981
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198104000-00003
Subject(s) - medicine , stomach , carcinoma , oncology , general surgery
Review of 298 cases of primary gastric malignancy from 1958 to 1978 revealed 265 cases of adenocarcinoma. Overall 5-year survival rate was a disappointing 5.5%, which was less than the earlier series of Oschner Clinic (7.5%). Curative resections produced a five-year survival rate of 26%. Patients presented with advanced disease; 84% had Stage III or IV disease at time of initial observation. The introduction of fiberoptic endoscopy during this period greatly enhanced the accuracy of preoperative diagnosis of tissue-proven cancer from 6% before fiberoptic to 58% since. Worldwide experience is much better, with overall five-year survival rate of 17.9%. Excellent survival statistics from Japanese studies reflect both the effects of mass surveying and early surgery and the prevalence of superficial spreading type of cancer. Improvement of results in this country will require more aggressive evaluation and earlier surgical intervention.