Pattern and surgical treatment of gastric cancer in Singapore

A personal series of 150 patients with gastric cancer operated on over an 11-year period in Singapore is reviewed. Cancer occurred in the antrum and/or body of the stomach in 117 patients and in the cardia in 33. Gastric tumours were well or moderately differentiated adenocarcinoma in 50 patients and poorly differentiated or signet ring cell carcinoma in 100. Surgical resection was performed on 115 patients, in whom it was palliative in 47. Attempted cure by R2 radical resection was performed in 68 patients: 14 with stage I, 12 with stage II and 42 with stage III disease. There was no operative death in these 68 patients. In 82 patients operated on more than 5 years ago, five patients with carcinoma of the cardia and 28 with cancer of the gastric antrum and/or body underwent curative resection. There were 12 known 5-year survivors among the latter 28 patients; 16 of the 28 had stage III disease, six of whom survived 5 years. These results compare favourably with those of an earlier report from Singapore in which there were no 5-year survivors. The improved results probably accrue from earlier diagnosis and the current policy of radical resection.