Gastric cancer: Australian outcomes of multi‐modality treatment with curative intent

• DOI: 10.1111/ans.12693
• Publication Date: 2014-05-21T08:05:51Z
• Authors: Yufei Chen; Nida Awan; Jan Willem Haveman; Christos Apostolou; David K. Chang; Neil D. Merrett
• Keywords: Male; 920102 - Cancer and Related Disorders; gastric cancer; 610; Adenocarcinoma; Prognosis; survival; Combined Modality Therapy; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Stomach Neoplasms; Humans; Female; Morbidity; New South Wales; 110323 - Surgery; Follow-Up Studies; Neoplasm Staging; Retrospective Studies

AbstractBackgroundGastric cancer is one of the leading causes of cancer‐related deaths worldwide. Large Western trials have shown overall 5‐year survival rates of 36–47%. Surgical resection remains the mainstay of curative treatment. We report the outcomes at a single Australian centre.MethodsWe analysed a prospectively kept database of patients after gastric resection for adenocarcinoma at a tertiary Australian hospital. Disease‐specific survival (DSS) was considered the primary end‐point.ResultsOne hundred and seventy‐three patients underwent gastrectomy with curative intent. Average age at diagnosis was 68, with 72% being male patients. One hundred patients had a total gastrectomy and 73 had subtotal. The average number of lymph nodes examined was 23. All patients were discussed in a multidisciplinary setting. Perioperative morbidity rate was 31%, with 3.5% 30‐day mortality. Five‐year DSS was 67.4% with 91.2%, 76.7% and 39.3% for stage 1, 2 and 3 disease, respectively. Five‐year overall survival considering death from any cause was 47.4%.ConclusionThis large Australian single centre study shows outcomes equivalent to other Western series and approaches that of Japanese data. High survival figures can be achieved when gastrectomy is performed by an experienced institution through a multi‐modality approach with adequate staging, aggressive and appropriate resection and selective use of perioperative therapy.