The rationale for early postoperative intraperitoneal chemotherapy for gastric cancer

  • W. J. Cunliffe
Part of the Cancer Treatment and Research book series (CTAR, volume 55)

Abstract

Gastric cancer is still a major source of morbidity and mortality worldwide [1], despite the falling incidence in many countries [2–4]. The average patient presenting with a primary gastric malignancy in Europe or the United States undergoing surgery will face a mortality rate of 10% or more, with fewer than 20% surviving 5 years [5]. In a large European study of over 13,000 patients [6], the 5- and 10-year survival was 5.5% and 3.8%, respectively, with 73% of patients not undergoing resection. An update of this study demonstrated that over a 25-year period, the incidence fell from 17.4/100,000 to 15.3/ 100,000, with 79% of patients having stage IV disease and with only 1 % having stage I disease; curative resection was undertaken in only 21 %, and the resulting mortality rate for partial and total gastrectomy was 13% and 29%, respectively; the 5-year survival rate was 5% overall [7]. In Japan, in contrast to these dismal results, a reduction in the operative mortality rate and a corresponding increase in the 5-year survival rate has been achieved [8]. This may well be as a result of the cooperation between endoscopists, surgeons, and pathologists [9], which will be discussed later. Both adjuvant radiotherapy and chemotherapy have been used in order to prolong survival, although so for without success [1], and this topic is fully discussed elsewhere in the book.

Keywords

Gastric Cancer Early Gastric Cancer Basal Cell Carcinoma Intestinal Metaplasia Peritoneal Surface 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 1991

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  • W. J. Cunliffe

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