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Changing patterns in gastric adenocarcinoma
G H Kampschöer1, T Nakajima, C J van de Velde
1Leiden University Hospital, The Netherlands.
The British Journal of Surgery
|September 1, 1989
Summary
Gastric cancer trends show an increase in proximal tumors and signet-ring cell carcinoma in Japan. Despite initial survival differences, stage-stratified analysis reveals comparable tumor behavior globally.
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- Gastric cancer incidence and characteristics vary geographically.
- Understanding temporal trends in gastric cancer is crucial for effective treatment and prevention strategies.
Purpose of the Study:
- To investigate changes in gastric cancer histology and tumor localization in Japan over two decades.
- To compare these trends with Western reports and assess their impact on patient survival.
Main Methods:
- Retrospective analysis of 2654 gastric cancer patients from the Cancer Institute Hospital, Tokyo.
- Data collected from two distinct periods: 1961-1965 and 1980-1984.
- Statistical comparison of tumor localization, histology, and survival rates between the two periods and with Western data.
Main Results:
- Significant increase in proximally localized tumors (17% to 27%) and signet-ring cell carcinoma (2% to 22%) over time.
- Proximal tumors were associated with advanced stage and poorer survival, but this difference disappeared after stage stratification.
- No significant difference in survival rates for signet-ring cell carcinoma compared to other gastric tumors.
Conclusions:
- Temporal shifts in gastric cancer in Japan mirror Western trends in tumor localization and histology.
- These similar epidemiological patterns suggest comparable tumor behavior across different geographical regions.
- Tumor-related factors, rather than geographical differences, may explain survival discrepancies between Japanese and Western gastric cancer patients.