Long term results in patients who survived five or more years after gastric resection for primary carcinoma

A personal series of 82 patients with primary carcinoma of the stomach operated upon between 1 January 1950 and 31 December 1973 survived five years, of longer, after the initial resection. Fifty-five patients were observed until the time they died, and 27 patients who are still alive have been observed from eight to 29 years. Many of the patients have lived into their 80's and 90's, with postoperative survival times of more than 20 years. Some of the long survival times followed both extensive operative procedures upon unfavorable lesions and operations upon patients who were in their 70's at the time of operation. A surprise finding as the cause of death was a recurrence of carcinoma in 13 patients, manifesting itself as long as 12 years after the initial operation. In six of the patients, the recurrence was confirmed at a second operation performed by me. The long term results in these patients seem to indicate that, except for the late recurrence of carcinoma, at least one-third of the patients may look forward to a normal life expectancy based upon their age at operation. The surgeon, therefore, should approach potentially curable carcinoma of the stomach with vigor and some optimism, even though the lesion is extensive or the patients are elderly, since a long healthy period of survival may be the reward.