EPIDEMIOLOGY AND PROGNOSIS OF GASTRIC-CAR CINOMA IN THE DEPARTMENT OFCALVADOS - A 10-YEAR SURVEY

Objectives. - The aim of this study was to determine trends in inciden ce and survival for gastric cancer in the department of Calvados over a ten-year period. Methods. - Between 1978 and 1987, 999 patients with gastric cancer were registered by the Registry of digestive tumours o f Calvados. Standardized incidence rates were calculated for males and females and for each site of the tumour in two consecutive 5-year per iods: period I: 1978-1982; period II: 1983-1987. Then prognostic facto rs were determined with univariate and multivariate methods. Results. - Global incidence rates were 15.7/100,000 in men, and 6.7/100,000 in women. Incidence rates of antropyloric carcinomas significantly decrea sed in women (period I: 3.6/100,000, period II: 2.1/100,000; P < 0.01) . The incidence rate of cancer of the cardia did not change in men (pe riod I: 2.7/100,000, period II: 2.9/100,000; NS) nor in women (period I: 0.6/100,000, period II: 0.3/100,000; NS). The ratio of early gastri c cancer was respectively 8 % and 9.2 % (NS). The frequency of ''signe t ring'' cells carcinomas increased from 20 % during period I, to 34 % during period II (P < 0.05). Overall 5-year survival rate was 16 %; i t was 26.3 % after resection, without significant change between the t wo periods (27 % versus 24.4 %). The multivariate study in gastric can cer after resection pointed out 5 prognostic factors: age over 75 year s, invaded resection margins, lymph node involvement, metastases and p arietal wall involvement. Conclusions. - The results of this epidemiol ogic study in the department of Calvados indicate that a) the global p rognosis of gastric cancer was poor and did not change over the 10 yea rs of the study; b) incidence rates of antropyloric carcinomas slightl y decreased in women; c) rates of early gastric cancers did not increa se.