Prognosis for surgically treated gastric cancer patients is poorer for women than men in all patients under age 50.

From 1965 to 1983, 1031 patients (689 men and 342 women) with advanced gastric cancer underwent gastric resection in our department. A retrospective study was done with special reference to the sex of the patients. The age, tumour size and location, Borrmann type, and histology were considered as the sex-related associations. The survival rate of women under age 50 years was lower than that of men, with a significant difference (P less than 0.01), and the 10-year survival rate was 39.2% for the men and 29.3% for the women. A multivariate analysis showed that the operative curability (relative risk: 2.11), lymph node metastasis (relative risk: 1.37), depth of invasion (relative risk: 1.30) and tumour size (relative risk: 1.05), all significant prognostic factors, differed between the men and women under age 50 years, and the survival rate for women was lower. Thus, early detection of gastric cancer is crucial to improve the survival of women under age 50 years. Postoperative chemotherapy may be considered for those with an advanced gastric cancer.