Treatment results for gastric cancer surgery: 12 years' experience at a single institute in Korea

Aims: To evaluate the changing trends of clinicopathologic features, surgical procedures and treatment outcomes of gastric cancer in a large-volume center. Methods: We divided the time period into two parts: the first is 1989-1996 (period I) and the second is 1997-2001 (period II). Then we analyzed prospectively collected data on 1816 patients treated at Kangnam St. Mary's Hospital, The Catholic University of Korea, from 1989 to 2001. Results: Upper one-third cancer was seen more prevalently in period II than period I (9.4% versus 6.6%) (p = 0.000) and total gastrectomy was performed more frequently in period II than period I (25% versus 18%) (p = 0.000). A diagnosis of early gastric cancer was made more prevalently in period II than period I (40% versus 27%) (p = 0.000). D2 lymphadenectomy was done in 74% of the period I patients and 83% of their period II counterparts (p = 0.000). Between the two periods, there was a significant difference in the incidence of operation-related major complications (9.9% in period I versus 3.9% in period II) (p = 0.000) and the mortality (1.8% versus 0.6%) (p = 0.023). The overall 5-year and 10-year survival rates were significantly higher in period II than period I (63% and 57% in period I versus 69% and 64% in period II) (p = 0.009). Conclusions: The overall survival of gastric cancer significantly increased because of the early detection and aggressive surgical approaches by experienced surgeons in a large-volume center. More effective multidisciplinary approaches are warranted to improve the prognosis of advanced gastric cancer.