Gastric carcinoma in Côte d'Or (France). A population-based study

The registry of digestive cancer in the Department of Cote d'Or, France, recorded newly diagnosed cases of gastric cancer between 1976 and 1980. The annual incidence rate, adjusted to the world population, was 15.2/100,000 for men and 6.1/100,000 for women. Stomach cancer incidence showed a substantial decline during the 5 yr of the study and this decline was more pronounced in men than in women. The operability rate was 62.4% and the resectability rate was 40.2%. Operative mortality after curative surgery was 17.6%. For all subjects, 17.6%, 29.1%, and 26.0% had localized, regional, and distant disease, respectively. The remaining 27.3%, not operated upon, with no evidence of metastases, had unclassifiable disease. The overall 5-yr corrected survival rate was 16.5%. In the absence of curative surgery all patients died in the 4 yr after diagnosis. After curative surgery the 5-yr corrected survival rate (excluding operative mortality) was 42.8%. The most important determinant of the survival was the pathological stage of the tumor. The age-corrected 5-yr survival was 98.7% for cases limited to the digestive wall, 45.5% for cases involving the serosa, and 26.6% for cases with locoregional extension. These results support the fact that, although declining, gastric cancer remains relatively frequent. Its overall prognosis in a well-defined population, where cases limited to the digestive wall are rare, remains poor.