Surgery and adjuvant chemotherapy for gastric cancer.

A review has been made of the results of surgical treatment of 8,000 cases of gastric cancer treated at the Cancer Institute Hospital, Tokyo, between 1946 and 1986. Resectability was 89.6%, and operative mortality 1.9%. The five-year survival rate was 37.4% for all cases, 59.4% for patients with curative surgery, and 5.0% for those with non-curative surgery. The curative rate improved more than twofold over 41 years among the patients with curative gastrectomy. No one survived more than five years who had visible tumor left after the surgery. Improvement was attributed to the increase in the incidence of early gastric cancer, and in part to surgery including systemic lymphadenectomy and combined resection of adjacent organs involved by cancer. Extensive intervention might be justifiable to eradicate the tumor when the surgery is curative, or relatively non-curative. Multimodality therapy is needed for the control of advanced cancer.