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

AimsTo evaluate the changing trends of clinicopathologic features, surgical procedures and treatment outcomes of gastric cancer in a large-volume center.MethodsWe 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.ResultsUpper 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).ConclusionsThe 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.