Clinical Study of Five-Year Survivors After Surgery for Gastric Carcinoma

Abstract

Summary Fifty-eight patients who survived for 5 years or longer after surgery for gastric carcinoma were studied. Nine patients died of other causes and 9 with recurrent carcinoma. Five-year survival does not mean cure. All recurrences in the present series occurred within 8 years after the operation. Neither the age of the patient, the type or duration of symptoms, nor the laboratory findings appeared related to survival. No patients had evidence of distant metastases. The presence of an abdominal mass or hepatomegaly did not preclude survival. The antrum was involved in 37 patients, the pars media in 24, and the cardia in only 7. The majority of the survivors had ulcerative lesions (27), polypoid lesions (16), or combined polypoid and ulcerative lesions (9) rather than infiltrative lesions (7). Subtotal resection, extensive in 9 patients, was performed in 53 patients, and total gastrectomy was performed in 6. Involvement of lymph nodes in 17 patients and extension of the carcinoma in 18 patients did not prevent 5-year survival. Adequate local excision, even with such extension or nodal involvement, may still result in 5-year survival. Histologic type can be of importance in survival since 31 of our survivors (54.4 per cent) had adenocarcinoma, whereas only 1 each had solid (medullary) or scirrhous carcinoma.