Gastric cancer: the French survey

Presentation of a multicentric retrospective french study concerning 4,655 cases of gastric cancer operated between 1980 and 1996. The mean age was 67.4 years old with a male predominance of 63.1%. Pains was the predominant presenting symptom (60%) followed by alteration of the general condition (44%) and anaemia (20%). 35.5% of tumors were of distal, 18.8% of middle and 18.6% of proximal localisation. As regard cancer stages, 40% were of stage I,-II and 60% of stages III,-IV. Subtotal gastrectomy was realised in 44%, total radical gastrectomy in 42.1% and other surgical procedures in 14% of cases (proximal gastric resection or atypical resection). D1 lymphadenectomy was associated in 58.4% and D2 in 41.6%. Morbidity was of 23% and mortality of 11.9% which passed from 19% during the first (1980,-85) to 8% in the last interval of time (1990,-96). The 5 years survival was 41% in case of gastric resection. In univariate analysis the 5 years relative survival was better in female patients (44% at 5 years), in patients younger than 50 years old (46%), when pain was the only clinical symptom (52.7%), in middle and distal third localisation (47%), in case of subtotal distal resection (47%) and in less advanced stages (79% at 5 years for stage I cancer). In multivariate analysis the 5 years survival was essentially correlated to the stage of the tumor and no real prognosis improvement was shown during the period of the study.