GASTRIC ADENOCARCINOMA: REVIEW OF 402 CASES IN 13 YEARS

Abstract

The records of 402 patients with adenocarcinoma of the stomach operated at the Hacettepe University Medical School Hospital between 1977 and 1989 were reviewed. The present study was undertaken to determine a better surgical treatment and prolong the survival. Extended gastric resections were found to be performed more frequently in the study period. The study design was retrospective. The chi-square test and t-test were used to compare intergroup differences. Differences between groups were considered significant at a p level less than 0.05. Resections were performed for 50% of patients. The most commonly performed type of resection was distal subtotal gastrectomy. The resection rate did not show any increase in the following years. The antral location of lesions was the most frequent site of occurrence. The site of invasion was found to have no effect on mortality. Gross invasion of the surrounding structures decreased the resection rate and increased the mortality rate. At the time of diagnosis, most of the patients (62%) were found to be at stage IV and resections were possible for 21% of the patients in this group. Extended resections did not alter survival significantly. The overall 5-year survival rate in our series was 6%. The results of operative management were not familiar to reports from Japan. We concluded that the prolonged survival is possible only with the screening programs and treatment of early detected cases.