Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma
| Autor: | J Berglund, Kurt Borch, Eric Kullman, Thomas Franzén, Lennart E. Franzén, Erkki Tarpila, Björn Jönsson |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care medicine.medical_treatment Adenocarcinoma Age Distribution Stomach Neoplasms medicine Humans Sex Distribution Stage (cooking) Survival rate Aged Neoplasm Staging Proportional Hazards Models Aged 80 and over Sweden business.industry Proportional hazards model Incidence Stomach Histology Middle Aged Prognosis medicine.disease Surgery Survival Rate medicine.anatomical_structure Multivariate Analysis Female Gastrectomy Radiology business |
| Zdroj: | British Journal of Surgery. 87:618-626 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1046/j.1365-2168.2000.01425.x |
| Popis: | Background There are indications that some features of gastric carcinoma are changing, with a possible impact on prognosis. The aim of this study was to examine any changes in type, location, stage, resection rate, postoperative mortality rate or prognosis for patients with gastric carcinoma in a well defined population. Methods During 1974–1991, 1161 new cases of gastric adenocarcinoma were diagnosed in Östergötland County, Sweden. Tumour location, Laurén histological type, tumour node metastasis (TNM) stage, radicality of tumour resection and postoperative complications were recorded after histological re-evaluation of tissue specimens and examination of all patient records. Dates of death were obtained from the Swedish Central Bureau of Statistics. Time trends were studied by comparing the intervals 1974–1982 (period 1) and 1983–1991 (period 2). Results The proportion of diffuse type of adenocarcinoma increased (from 27 to 35 per cent), while that of mixed type decreased (from 16 to 9 per cent) and that of intestinal type was unchanged. The proportion of tumours located in the proximal two-thirds of the stomach increased (from 32 to 42 per cent) and the proportion of patients with tumours in TNM stage IV decreased (from 32 to 25 per cent). Overall tumour resection rates were unchanged, although the proportion of radical total gastrectomies increased (from 36 to 50 per cent). Excluding tumours of the cardia or gastric remnant after previous ulcer surgery, the 5-year relative survival rate after radical resection increased from 25 to 36 per cent and the postoperative mortality rate decreased for both radical (from 11 to 4 per cent) and palliative (from 18 to 6 per cent) resection. Conclusion The patterns of tumour histology, location and stage of gastric carcinoma have changed in the authors' region. These changes were paralleled by a significant improvement in survival and postoperative mortality rates. |
| Databáze: | OpenAIRE |
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