Population-based study of diagnosis, treatment and prognosis of gastric cancer

Br J Surg. 1997 Oct;84(10):1474-8.


Background: Gastric cancer remains a common cancer with a poor prognosis. Improving trends seen in Japan have not yet been observed in Western countries.

Methods: A population-based series of 1329 patients with gastric cancer diagnosed over an 18-year period in Côte d'Or, France, was used to establish time trends in diagnostic strategy, treatment and prognosis.

Results: The use of endoscopy alone increased from 2.7 per cent in 1976-1978 to 76.6 per cent in 1991-1993 (P < 0.0001). This trend was associated at first with a significant decrease in the use of radiography alone, then by a significant decrease in the use of both radiography and endoscopy. The proportion of resections for cure increased from 37.9 per cent in 1976-1978 to 50.0 per cent in 1991-1993 (mean 3-year variation + 5.8 per cent, P < 0.01). The proportion of cases confined to the gastric wall increased from 6.1 to 11.7 per cent (mean 3-year variation + 13.1 per cent, P < 0.01), while the proportion of other stages remained stable. The operative mortality rate decreased dramatically from 25.6 per cent in 1976-1978 to 13.6 per cent in 1991-1993 (P < 0.001) and the 5-year relative survival rate rose from 12.8 per cent in 1976-1978 to 26.4 per cent in 1988-1990 (P < 0.001).

Conclusion: This study has demonstrated that improvements in the care of patients with gastric cancer have been achieved, but that further progress may be made.

MeSH terms

  • Adult
  • Aged
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / mortality
  • Stomach Neoplasms* / therapy
  • Survival Analysis
  • Survival Rate