[Radical surgery in stomach cancer]

Abstract

One hundred ninety-six patients with gastric adenocarcinoma underwent surgical resection at the Istituto di 1a Clinica Chirurgica di Padova from 1983 through 1997. Sixty-six patients (66%) underwent total gastrectomy and 53 patients (36.2%) subtotal distal gastrectomy macroscopically curative (H0, P0, S0-2, R0), in all the cases associated to incomplete D2-D3 loco-regional lymphadenectomy. Postoperative morbidity was zero after partial gastrectomy and 3% after total gastrectomy. Five-year survival, analyzed retrospectively, after total gastrectomy was 75% for stage I and II (56% in presence of lymph nodes metastases and 94% in absence) and 15% for stage III and IV; it was instead 65% for stage I and II (57 in presence of lymph nodes metastases and 73% in absence) and 50% for stage III and IV after partial gastrectomy. In a prospective study 5-year actuarial survival was 61% after total standard gastrectomy, 76% in the extended forms and 91% after partial gastrectomy, overall 5-year survival in stage I and II was 70%.