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June 3, 1974

Cancer of the Gastrointestinal Tract: D. Gastric Cancer: Treatment Principles

JAMA. 1974;228(10):1283-1286. doi:10.1001/jama.1974.03230350053036

DESPITE the gains in therapeutic techniques, there has been no major improvement in the long-term survival of patients with stomach cancer. The detection of gastric cancer through clinical and roentgenographic findings pronounces a death sentence on the patient; merely the overt recognition of this cancer is a sign of advancement. Most clinical reports read the same1,2: for every 100 patients, 60 to 80 undergo exploratory surgery; resections are performed in 30 to 40, and 5% to 15% survive, depending on the number of patients in whom disease is limited to the stomach. Marshall3 has shown that the five-year survival decreases from 34.8% to 7.2% when lymph nodal invasion occurs. This is the most critical factor in determining prognosis; lymph node invasion is present in two thirds of patients who undergo resection.3

There is little correlation between the aggressiveness of surgical resection and the ultimate outcome for the patient. The