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June 1975

Surgical Treatment of Gastric Carcinoma: A Regional Study of 2,590 Patients Over a 27-Year Period

Author Affiliations

From the Department of Surgery, University of Turku, Turku, Finland.

Arch Surg. 1975;110(6):703-707. doi:10.1001/archsurg.1975.01360120021003

A series of 2,590 gastric carcinoma patients were studied in Finland over a 27-year period, divided into three time periods. The proportion of patients not operated on dropped from 46% in period 1 to 20.7% in period 3. The proportion of patients receiving total or proximal gastrectomy rose from 0.9% to 23%. Resectability rose from 21,1% in period 1 to 45.1% in period 3, the most distinct improvement being noted in carcinoma of the cardia. The operative mortality of proximal or total gastrectomy was about 16%; for distal gastrectomy for cure, 4.8%. Five-year survival for curative subtotal gastrectomy rose from 23% in period 1 to 43% in period 3; for proximal or total gastrectomy, from 0 (only 9 were done in that period) to 30%. Despite the higher primary mortality, carcinoma of the cardia has a prognosis as good as that for carcinoma of the antrum.