Gastric carcinoma. Experience from 1916 to 1949 and present concepts

Some Aspects of the Gastric Cancer Problem

“…Coller and his associates (16) carefully examined resected specimens for evidence of extension into the duodenum and found such evidence in 26.4 per cent of patients. Harvey and his associates (17) found duodenal involvement in 20 per cent of resected specimens and esophageal involvement in 37 of 270 cases. Ranson (18) made detailed studies of specimens removed from the upper and lower ends of operative specimens in 44 cases of total gastrectomy.…”

Use of Thoracicoabdominal Incision for Upper Abdominal Neoplasms

“…A similar report has more recently been presented by McNeer and associates 9 and by Harvey and others. 10 Thus there appears to be evidence that resection of multiple organs not only is practical but also is justified on pathological and anatomical grounds. It would appear that neoplasms other than carcinoma could be similarly attacked.…”

Long survival after carcinoma of the stomach

“…Although reluctant to accept the likelihood of a carcinomatous ulcer existing in the stomach for 10 to 30 years without metastasizing this is perhaps not as impossible as would appear on first reflection because the progress of carcinoma in the stomach may be very slow indeed. In three of the 60 patients of Harvey, Titherington, Stout, and St. John (1951), surviving for five years following resection, that resection was actually through carcinomatous tissue, and Walters and Tama (1961) report two patients 118 Long survival after carcinoma of the stomach who survived resections for 41 and 26 years only to die with local recurrences.…”

“…Ransom (1953) reported a five-year survival of only 6-7 Y. of patients submitted to total gastrectomy. Harvey et al (1951) comment that 'the higher the resectability rate the less the increase in the survival rate achieved'. Ultraheroic surgery may achieve for the patient no more than a miserable short-term survival.…”