CARCINOMA OF THE STOMACH FOLLOWING THE CHERNOBYL NUCLEAR ACCIDENT

Medical consequences of many nuclear accidents on humans are well stud ied, but the results pertaining to gastric cancer patients who were ex posed to radiation as a result of the Chernobyl nuclear accident have not been analysed. In this study, the outcome of the surgical treatmen t of 68 gastric cancer patients who were exposed to radiation as a res ult of the Chernobyl nuclear accident was compared with that of 117 co nsecutive gastric cancer patients from uncontaminated areas of the Ukr aine. Patients in the study group was significantly younger than that of the control group. Comparative analysis showed the same frequency o f regional metastases (65.7% versus 71.1%, P > 0.05), but a smaller nu mber of distant metastases (23.8% versus 38.1%, P < 0.05) in the study group. 41.2% of patients in the study group underwent total gastrecto my compared to 19.6% of patients in the control group (P= 0.002). Post operative complications developed in 13.2% of patients in the study gr oup, while postoperative mortality in the study group was 7.3% compare d to 1.7% in the control group. A significant decrease in CD16 cells w as noted in patients from the study group following the operative proc edure. Young age, invasive tumours with smaller number of distant meta stases, frequent necessity for total gastrectomy and combined operatio ns with adjacent organs, a higher level of postoperative morbidity and mortality and low levels of natural killer cells (CD16+) with a tende ncy to decrease after surgery are characteristic of patients with carc inoma of the stomach affected by the Chernobyl accident. (C) 1997 Else vier Science Ltd.