[Centralized treatment of patients with stomach cancer]

An analysis of surgical results versus the specialization of medical establishments was carried out on the basis of 6,220 primary cases of stomach cancer registered in the GDR in 1976. Operability and radical resectability accounted for 56.0 and 21.0%, respectively. Postsurgical lethality was 20.6%. Relative and absolute 5-year survival were 24.7 and 5.1%. In the establishments of the first group (1-4 radical operations per year), operability and resectability were 53.7 and 13.2%; in the second group (5-19 radical operations per year) -65.2 and 28.2%, and in the third group (more than 20 radical operation per year) -80.9 and 38.5%, respectively. The following distinct differences in postoperative death rates versus patients' age and surgical procedure were obtained: after distal resection, postoperative mortality was 20.7 (group 1), 16.8 (group 2) and 10.1% (group 3), respectively. Priesching s index of efficacy based on long-term survival data was 35 (group 1), 6.8 (group 2) and 11.3 (group 3). Although not all the evidence elicited by the present study was statistically significant, it pointed to distinct tendency of better results being obtained at specialized establishments with a higher turnover of surgical cases.