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June 3, 1974


JAMA. 1974;228(10):1290-1291. doi:10.1001/jama.1974.03230350060040

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GASTRIC carcinoma, even with a decreasing incidence, remains a major malignant disease in the United States and ranks fifth among causes of cancer death. Despite efforts at early diagnosis and the valiant attacks by the surgeon, end-result statistics still show that nine of every ten gastric carcinoma patients will die of this disease. Regretably, this dismal statistic has changed little if at all over the past quarter century. The overwhelming majority of patients with this very common cancer, therefore, become challenges for medical treatment. The primary decision that the physician must reach is whether to treat with symptomatic and supportive measures only or to consider systemic chemotherapy. The progression of unresectable gastric cancer is usually rapid (a median survival of only four months in 307 untreated patients we studied23), and this decision must be made early in the course of the disease. A persistent opinion expressed in both medical