Changing patterns in advanced gastric carcinoma

A retrospective study on patients with gastric cancer during the periods;19 84-88 (n = 63 patients) and 1989-93 (n = 59 patients) was made. The aim of the study was to assess any changing patterns in tumour distribution, surgi cal management and survival during the two periods. When the diagnosis was made, the majority of tumours were advanced: 58 were stage IV and 21 were s tage IIIB, with 43 tumours at earlier stages. The incidence of proximally l ocated gastric adenocarcinomas increased from 15.9 to 27.1%, while the inci dence of carcinomas located in the body decreased from 34.9 to 23.7%. The m ajority of patients underwent conservative gastrectomy. The proportion of p roximal gastrectomies increased from 3.2 to 15.3 per cent (p = 0.02), where as the proportion of combined resection of adjacent organs decreased from 3 8.1 to 22.0 per cent (p = 0.04). Perioperative mortality rate decreased fro m 17.5 to 1.7 per cent (p = 0.003). Prognosis remained unchanged in the two periods; overall 5-year survival is calculated as 12 per cent.