Trends in clinical features, postoperative outcomes, and long-term survival for gastric cancer: a Western experience with 1,278 patients over 30 years

Abstract

BackgroundThe aim of the present study was to identify temporal trends in long-term survival and postoperative outcomes and to analyze prognostic factors influencing the prognosis of patients with gastric cancer (GC) treated in a 30-year interval in a tertiary referral Western institution.MethodsBetween January 1980 and December 2010, 1,278 patients who were diagnosed with GC at the Digestive Surgery Department, Catholic University of Rome, Italy, were identified. Among them, 936 patients underwent surgical resection and were included in the analysis.ResultsOver time there was a significant improvement in postoperative outcomes. Morbidity and mortality rates decreased to 19.4% and 1.6%, respectively, in the last decade. By contrast, the multivisceral resection rate steadily increased from 12.7% to 29.6%. The overall five-year survival rate steadily increased over time, reaching 51% in the last decade, and 64.5% for R0 resections. Multivariate analysis showed a higher probability of overall survival for early stages (I and II), extended lymphadenectomy, and R0 resections.ConclusionsOver three decades there was a significant improvement in perioperative and postoperative care and a steady increase in overall survival.

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The prevalence of histologic atrophy and intestinal metaplasia in the corpus has decreased over 15 years in females in the Korean population

“…And higher incidences of gastric cancer are found in countries in eastern Asia than in other countries . Although early GC has a 5‐year survival rate of 90% or more with complete resection, advanced GC is known to have poor prognosis even if resection is possible . Therefore, it is important to prevent the progression of GC to advanced GC in the high‐risk group by early endoscopic screenings .…”

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“…Key types of endoscopic treatment include endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) (5,6). Despite improvements in treatment efficacy, prognoses for gastric cancer remain poor (7). A potential reason for this may be that patients are diagnosed on the basis of advanced symptoms of late stage gastric cancer, which limits their treatment options.…”