Gastric carcinoma: 30-year review

Area of Science:

• Oncology
• Surgical Gastroenterology
• Medical History

Background:

• Gastric carcinoma treatment has evolved significantly over decades.
• Understanding historical surgical outcomes is crucial for current practice.
• Long-term survival data for gastric cancer from mid-20th century are limited.

Purpose of the Study:

• To analyze surgical outcomes for gastric carcinoma patients treated between 1941 and 1970.
• To evaluate trends in operability, resectability, and survival rates over two decades.
• To assess the impact of different surgical procedures on patient survival.

Main Methods:

• Retrospective analysis of 1030 gastric carcinoma patient records from 1941-1970.
• 10-year follow-up data for 1024 patients.
• Calculation of operability, resectability, and survival rates (5- and 10-year).

Main Results:

• Operability (80.9%) and resectability (53.5%) rates increased significantly from 1951-1960 to 1961-1970.
• Subtotal gastrectomy rate increased to 46.9%, with 59.5% for cure and 40.5% for palliation.
• No significant improvement in overall 5-year survival (15.1%) or 10-year survival (6.6%) was observed.
• Total gastrectomy showed limited long-term survival, with only 5 of 56 patients surviving 5+ years.
• Linitis plastica had equal incidence in men and women, with lower resectability and a 90.6% 1-year death rate.

Conclusions:

• While surgical techniques and rates for gastric carcinoma improved between 1941-1970, overall long-term survival rates remained largely unchanged.
• Subtotal gastrectomy was the primary approach for cure and palliation.
• Total gastrectomy and gastroesophagectomy were associated with high morbidity and low survival rates.