Surgical management of gastric cancer--a personal series of 160 cases.

A personal series of 160 patients with gastric cancer operated over a twelve-and-a-half-year period in Singapore is reviewed. Cancer occurred in the antrum and/or body of stomach in 125 patients. Surgical resections were performed on 125 patients, 53 of which were palliative. Attempted cure by R2 type radical resection was performed on 72 patients--14 patients with Stage I disease, 13 patients with Stage II disease and 45 patients with Stage III disease. There was no operative mortality in these 72 patients. In the cohort of 89 patients operated more than five years ago, six patients with cancer of cardia and 33 patients with cancer of gastric antrum and/or body underwent curative resection. There were 13 known five-year survivors amongst these latter 33 patients; 20 of these patients had Stage III disease and six of these were five-year survivors. Gastric cancer in Singapore continues to present at a late stage of disease. Though apparently falling short of the excellent results reported from Japan, our preliminary five-year survival figures compare favourably with many Western series. The existence of different biological forms of cancer has been suggested to be an important factor to explain the wide difference in results. However, perhaps of greater importance is the extent of surgical resection--R2 type resection having improved prospects of cure in a disease notorious for its poor prognosis.