Improving survival in gastric cancer: Review of 5-year survival rates in English language publications from 1970

Abstract

In this review of English language publications from 1970, 5-year survival rates after surgery for gastric cancer have been analysed. While the proportion of patients coming to operation has fallen from 92 per cent before 1970 to 71 per cent by 1990, the proportion of operated patients undergoing resection has increased from 37 per cent before 1970 to 48 per cent before 1990. This change suggests improved preoperative staging leading to better patient selection for operation. The 5-year survival rate following all resections has increased significantly from 20.7 per cent before 1970 to 28.4 per cent before 1990, an increase of 7.7 per cent (95 per cent confidence interval 7.1-8.3 per cent). The 5-year survival rate following curative or radical resection has risen from 37.6 to 55.4 per cent over the same period, an increase of 17.8 per cent (95 per cent confidence interval 17.1-18.5 per cent). It is likely that this improvement has contributed to the decrease in the mortality rate from gastric cancer. Comparison of Japanese series with others suggests that diagnosis and treatment of the disease at an earlier stage will result in an even greater increase in 5-year survival rates outside Japan. Of the papers studied, 56 per cent were excluded from analysis, the majority because the data provided about 5-year survival rates were insufficient or the survival calculations inappropriate. Results of survival after operations for gastric cancer should be calculated and presented in a standardized manner.

Role of symptoms in diagnosis and outcome of gastric cancer

“…On the contrary, survival rates in Western series are still dismal, ranging between 8% and 26% [33][34][35][36][37] . One of the main reasons for this discrepancy is the efficacy of screening programmes in Japan, where the high incidence and awareness of the condition, and ready access to endoscopy have led to cancers usually being diagnosed in asymptomatic patients or in patients with minor dyspeptic symptoms [38] .…”

The Essentials of Locoregional Control in the Treatment of Gastric Cancer

“…At the start of the trial,h istorical data wereu sed to calculatee xpected 5-year survivalr ates after dissection with curativei ntent: 20% for patients who underwent aD 1d issection and 32% for patients who had aD 2d issection (2,28). Although the trial could not demonstrate ad ifference in overall survival, 5-year survival rates weremuch higher than expected: 45% after aD1dissection and 47% after aD2dissec-tion (Table 1) (30).…”

“…Survival rates after gastric resection areconsistentlyhigher in Japan than in Western countries (1,2). One of the reasons is that in Japan tumours arefound in aless advanced stage due to large scale screening programs of this high risk population (3).…”

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

“…When a recurrent tumor develops in the remnant stomach after subtotal gastrectomy, treatments such as chemotherapy and an additional operation with curative intent can be offered. However, despite advances in the management of recurrent gastric cancer, several studies have reported a poor prognosis for patients with recurrent gastric cancer [2,5,7,9,10]. Imaging modalities, including contrast-enhanced computed tomography (CECT) and endoscopy, have been used for the detection of gastric cancer recurrence [4,11,12].…”