1994 Volume 55 Issue 11 Pages 2749-2754
Chronological changes in the morphological features of gastric cancer and associated treatment modalities and their long term results were reviewed in this study. Subiects were 1751 cases of solitary gastric cancer out of 2169 cases of gastric cancer operated on at the department over the past 35 years, and they were divided into four periods for comparison. The notable feature was the percentage increase in early gastric cancer and in fact, the rate was 40.8% of all gastric cancers operated on between 1985 and 1990, versus 9.2% in the early period. The age has shifted to the elderly population. Regarding the location of the cancer, the incidence of the upper part and the greater curvature of the stomach increased. When classified according to macroscopic criteria, type IIa and IIc showed increased in early gastric cancers, while lesions exhibiting type features were less frequent. Among advanced cancers, the incidence of type 5 increased, while type 2 was less frequent. With regard to histological types of the cancers, the incidence of moderately differentiated adenocarcinoma increased. Although extent of cancer spread has shifted to earlier stage, a recent increase in stage IV was also noted, resulting that the rate of curative surgery did not increase. Five-year survival rates increased during the past 35 years in patients in stage I, II and III, but in patients in stage IV it still remained under 10%. Chronological changes in the operation were increase in wide resection, systemic lymphatic dissection and associated resection of other organs for cure.
