The aim of this study was to document patterns of survival after resection
for cure for gastric cancer in a well-defined Population A population-based
series of 649 gastric cancers resected for cure between 1976 and 1995 in a
494000 population, was used. Resection for cure was performed in 44.4% of
the diagnosed cases. This proportion increased From 36.8% (1976-1979) to 45
.0% (1992-1995) (P = 0.03) whilst operative mortality decreased from 18.3 t
o 12.7% (P=0.003). The overall crude 5-year survival rate (excluding operat
ive mortality) was 32.6% (95% confidence interval (CI) 28.7-36.5) and the c
orresponding relative survival late was 40.9%. Prognosis did not improve du
ring the study period. Stage at diagnosis was the most important prognostic
factor, the 5-year relative survival rate being 81.2% (+/- 5.9) in TNM sta
ge IA, 70.9% ( +/- 8.0) in stage IB, 50.4% (+/- 4.6) in stage II, 24.4% (+/
- 3.7) in stage IIIA, 5.6% (+/-3.2) in stage IIIB and 5.2% (+/- 2.2) in sta
ge IV. Stage at diagnosis, age, subsite and macroscopic typo of growth were
independent prognostic factors. in a multivariate relative survival model.
Earlier detection or development of an effective adjuvant therapy could co
ntribute to improvement in prognosis. (C) 2000 Elsevier Science Ltd. All ri
ghts reserved.