Abstract
This study was conducted to define the pattern and results of gastric cancer surgery in Singapore by reviewing the epidemological data from the Singapore Cancer Registry together with a review of a personal series of 182 patients operated on over a 14 1/2-year period. As in Japan and the West, the incidence of gastric cancer is decreasing in Singapore; it was 2.3% per year for men and 1.5% for women in the period 1968–1982. Nevertheless, the disease is still common and the respective age-standardized rates among the ethnic Chinese in Singapore of 37.3 and 15.4 per 100,000 per year remain higher than in the West but are only about half the rate observed in Japan. These rates in Singapore Chinese are also higher than those seen in the Chinese-Americans in the United States, but are lower than those of the Chinese of Shanghai, which suggests that lifestyle and diet influence the incidence of gastric cancer. In the series of 182 patients, gastric adenocarcinoma occurred in the antrum or body or the whole stomach in 78.5% and in the cardia in 21.5%. Presentation was late: stage I, 10%; stage II, 7.7%; stage III, 28%; and stage IV, 54.3%. Surgical resection was performed whenever technically possible (146 patients, 80%). In 86 patients, all macroscopic tumors were excised by a radical resection approximating the R2 type of resection, with only one operative mortality. In the cohort of patients operated on more than 5 years ago for carcinoma of the antrum or body, 25 of 51 patients have survived 5 years; 30 patients had stage III disease and 12 of these are 5-year survivors. The results of the present series of advanced gastric carcinoma treated by radical resection outside Japan appears encouraging in terms of the low operative mortality and long-term survival.
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References
Lee HP, Chia KS, Shanmugaratnam K (1992) Cancer incidence in Singapore, 1983–87, Singapore Cancer Registry. Report no 3
Ti TK (1986) Radical surgery for gastric and oesophageal cancer: a Singapore experience. J R Coll Surg Edinb 31:277–281
Ti TK (1988) Five year survival following radical surgery for cancer of the stomach and oesophagus. Ann Acad Med Singapore 17:42–47
Ti TK (1993) Pattern and surgical treatment of gastric cancer in Singapore. Br J Surg 80:886–889
Ti TK (1993) Surgical management of gastric cancer — A personal series of 160 cases. Ann Acad Med Sing 22:146–150
Japanese Research Society for Gastric Cancer (1981) The general rules for the gastric cancer study in surgery and pathology. Jpn J Surg 11:127
Kennedy BJ (1987) The united international gastric cancer staging classification. Scand J Gastroenterol 133 [Suppl]: 11–13
Husemann B (1989) Cardia carcinoma considered as a distinct clinical entity. Br J Surg 76:136–139
Wee A, Kang KY, Teh M (1992) Helicobacter pylori and gastric cancer: correlation with gastritis, intestinal metaplasia and tumor histology. Gut 33:1029–1032
Maruyama K, Okabayashi K, Kiroshita T (1987) Prognosis in gastric cancer surgery in Japan and its limits of radicality. World J Surg 11:418–425
Allum WH, Powell DJ, McConkey CC, Fielding JWL (1989) Gastric cancer: a 25-year review. Br J Surg 76:535–539
Siewert JR, Bottcher K, Roder JD, Busch R, Hermanek P, Meyer HJ and the German Gastric Carcinoma Study Group (1993) Prognostic relevance of systemic lymph node dissection in gastric carcinoma. Br J Surg 80:1015–1018
Pacelli F, Doglietto GB, Bellantone R, Alfieri S, Sgadari A, Crucitti F (1993) Extensive versus limited lymph node dissection for gastric cancer; a comparative study of 320 patients. Br J Surg 80:1153–1156
Ong SC, Rauff A, Yeo KQ, Wu DC (1973) Carcinoma of the stomach: a review of 112 cases. Proceedings of the 8th Singapore-Malaysia Congress of Medicine, pp 116–119
Furakawa H, Hiratsuka M, Iwanaga T (1988) A rational technique for surgical operation: on Borrmann type 4 gastric cancer left upper abdominal evisceration plus Appleby's method. Br J Surg 75:116–119
Nishi M, Kajitani T (1970) Pancreatic duodenectomy against gastric cancer. Rinsho-geka 32:887
Stewart JR, Hoff SJ, Johnson DH, Murray MJ, Butler DR, Elkins CC, Sharp KW, Merrill WH and Sawyers JL (1993) Improved survival with neoadjuvant therapy and resection for adenocarcinoma of the oesophagus. Ann Surg 218:571–578
Orringer MB, Forastiere AA, Perez Tamayo C, Urba S, Takasugi BJ, Bromberg J (1990) Chemotherapy and radiation therapy before transhiatal oesophagectomy for oesophageal carcinoma. Ann Thorac Surg 49:348–355
Jin-Pok Kim, Kwon OJ, Oh ST, Yang HK (1992) Results of surgery on 6589 gastric cancer patients and immunochemotherapy as the best treatment of advanced gastric cancer. Ann Surg 216:269–279
Kyoto Research Group for Digestive Organ Surgery (1992) A comparative multi-institutional study on post operative adjuvant immunotherapy with oral streptococcal preparation on 432 for patients after gastric cancer surgery. Ann Surg 216:44–54
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Ti, T.K. Radical surgery for gastric cancer in Singapore. Surg Today 25, 573–578 (1995). https://doi.org/10.1007/BF00311428
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DOI: https://doi.org/10.1007/BF00311428