[Epidemiology and treatment of stomach cancer: news in 1992].

Four studies presented at the 1992 ASCO and AACR meetings are analysed. Wanebo compared treatment of gastric cancer in the USA and in Japan. Retrospective analysis of 18,365 patients showed an important delay in diagnosis and surgical treatment without radical lymph node dissection (less than 10%) in the North-American patients. In 1982, the overall 5-year survival in the USA was 17.5%, not different from that of thirty years ago. MacDonald undertook a prospective randomised study of adjuvant FAM chemotherapy in 221 patients operated on for gastric cancer. With a median follow-up of 7 years, the median overall and disease free survival were respectively 36 and 29 months in the FAM group and 28 and 22 months in the control group. These differences were not significant and the authors concluded that FAM is not an effective adjuvant chemotherapy in resected gastric cancer. Ajani studied the efficacy of pre and post-operative EAP (etoposide, adriamycin, platine) chemotherapy in fourty-eight patients with potentially resectable gastric carcinoma. The overall clinical response rate was 31%, fourty-one patients were operated on and thirty-seven had a curative resection (70%). There was one chemotherapy related death. These data indicate that pre and post-operative EAP chemotherapy is feasible and effective in patients with potentially resectable gastric carcinoma. Correa made a lecture on human gastric carcinogenesis. The "intestinal" type of gastric cancer appears to be the end result of a long series of cellular changes called "multifocal chronic atrophic gastritis". Alterations in the function of the gland neck cells appear to be responsible for the preneoplasic changes.(ABSTRACT TRUNCATED AT 250 WORDS)