Results of surgical treatment of gastric cancer--special reference to pathological findings.

During 16 year period from 1967 to 1982, a total of 1,471 patients with gastric cancer were surgically treated at the authors' clinic and 1,347 of them underwent gastric resection. The 5-year survival rate for 692 of curatively operated patients was 73.8%, in contrast to 11.8% for non-curatively operated cases. A correlation study disclosed the depth of cancer infiltration and the extent of lymphnode metastasis to be most reliable prognostic factors. The 5-year survival rate for stage I cases was 91.0%, 70.0% for stage II, 46.7% for stage III, and 8.6% for stage IV. An improvement in the end-results was attributed mainly to the increased incidence of early cancer in surgical cases, and partially to proper adjuvant chemotherapy for the advanced cancer cases during or long-term after surgery. In fact, the cases of early gastric carcinoma whose depth invasion was limited within the mucosa or submucosa constituted 41.9% of the authors' surgical series in 1967-1982, and 5-year survival rates of patients in stages II, III and IV receiving cancer chemotherapy strikingly improved to 80.6%, 57.3%, and 13.2%, in contrast to 59.7%, 35.2% and 2.4% for control groups not treated with anticancer agents.