Changing trends in gastric carcinoma at a university medical center: a twelve-year retrospective analysis.

Over the past 60 years, the epidemiology of gastric adenocarcinoma has changed considerably. The most striking change in the epidemiology of gastric adenocarcinoma has been the rapid increase in cancers of the proximal stomach. We performed a retrospective analysis of all gastric adenocarcinomas diagnosed at two hospitals in Little Rock, Arkansas, U.S.A., between 1985 and 1996. Two hundred seventeen patients were diagnosed with gastric adenocarcinoma. Patients were divided into three 4-year cohorts. We found that the proportions of gastric cardia adenocarcinoma in cohorts 1, 2, and 3 were 31%, 36%, and 42%, respectively (p = 0.52). Median survival in the three cohorts was 5, 8, and 8 months, respectively (p = 0.22). Median survival (stages 1-4) was 41.5, 11.5, 10, and 3 months, respectively (p < 0.0001). Well-, moderately-, and poorly- differentiated adenocarcinoma had median survivals of 18, 7.5, and 6 months, respectively (p = 0.07). We concluded that patients with gastric adenocarcinoma continue to be diagnosed at late stages. There has been a trend toward an increasing proportion of cardia adenocarcinoma. Stage at presentation was the only significant predictor of survival.