Surgical treatment of gastric cancer: a retrospective study with special reference to epidemiology

The present retrospective study gives the analysis of the epidemiological data of 1474 patients with gastric cancer, who were operated on at the 1st Department of Surgery of the University Medical School of Debrecen in the course of 35 years. In spite of the changes in diagnostics and therapeutic management it was impossible to raise, during this period, the rate of resectability: in the first 10 years it was 56%, and 55% in the last five years. There was no improvement in the proportion of curative and palliative resection, either: 50/6 vs 49/6. The number of gastrectomies increased to 22.5% from 17%, in a quarter of the cases, in the last two periods, extended multivisceral interventions were also performed. In the location of resectable carcinomas the number of those spreading over more than one third increased from 2% to 7%, and similar growth was encountered in the rate of diffuse-type carcinomas. The postoperative surgical complications decreased to 18% from 27%, and early postoperative death from 19.6 to 10.1%. In the last two periods 46% of the patients were admitted in advanced stages of tumor (UICC III B or IV), with half a year's or longer histories. Exclusively surgical treatment is not effective in these cases.