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Gastric AdenocarcinomaA Disease in Transition
Blake Cady, MD;
Ricardo L. Rossi, MD;
Mark L. Silverman, MD;
William Piccione, MD;
Thomas A. Heck, MD
Arch Surg. 1989;124(3):303-308.
Abstract
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• Two hundred eleven gastric adenocarcinomas diagnosed from 1967 to 1982 were analyzed. Thirty-four percent had a proximal location, a proportionate increase from previous decades that suggested a distinctive epidemiology. Diffuse histology occurred in 49% of cases overall and in 55% of unresectable cases, which were also increases from previous decades. No deaths followed curative resections, two (4%) of 50 patients with palliative resections died, and three (6%) of 54 patients who underwent exploration without resection died, indicating improved operative management. Superficial gastric cancer constituted 6% of cases; 91% were cured. Seventeen percent of cases were linitis plastica and required total gastrectomy in 77% of resections; only 13% of patients had curative operations; none were cured. Seventy-nine percent of cases were polypoid or ulcerated focal cancers. Of operable focal cancers, 72% were resected; 27 (47%) of 57 patients who underwent resection for cure survived five years, a distinct improvement from previous reports, as was the overall survival of 21%.
(Arch Surg 1989;124:303-308)
Author Affiliations
From the Department of Surgery, New England Deaconess Hospital, Boston (Dr Cady); Departments of General Surgery (Dr Rossi) and Pathology (Dr Silverman), Lahey Clinic Foundation, Burlington, Mass; Department of Thoracic Surgery, Presbyterian–St Luke's Hospital, Chicago (Dr Piccione); and Department of Surgery, Good Samaritan Hospital, Dayton, Ohio (Dr Heck).
Footnotes
Accepted for publication Oct 23, 1987.
Read before the Annual Meeting of the Society of Surgical Oncology, London, April 28, 1987.
Reprint requests to 110 Francis St, Boston, MA 02215 (Dr Cady).
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