Chronological Changes of Gastric Cancer in Community Hospital

Jung, In Mok; Kong, Seong Ho; Suh, Jun Suk; Kim, Young Chul; Heo, Seung Chul; Ahn, Young Joon; Kim, Soo Jin; Kwon, Oh Joong; Chung, Jung Kee

Abstract

PURPOSE
Gastric cancer remains the most common type of cancer in Korea, however, early diagnosis and surgical advancements have resulted in a better prognosis in the last few decades. The aim of this study was to investigate chronological changes of the clinicopathological features in patients with primary gastric cancer who had undergone gastric operations in Department of Surgery of Seoul Municipal Boramae Hospital. METHOD: Between November 1991 and April 2001, 634 primary gastric adenocarcinoma patients having undergone gastric operations were included in this study and divided into the two groups: 298 patients between 1991 and 1996 (early group) and 336 patients thereafter (late group). The clinicopathological characteristics, including age, gender, type of operation, gross and histologial findings, stage, and ratio of early gastric cancer, were compared between the two groups. RESULTS: The overall male-to-female ratio was 2: 1, with a mean age of 59.0 years. As the community hospital, eighty two percents of patients were resident within the same administrative district. There were no statistical differences in age, gender, type of operation, and total number of resected lymph nodes between the two groups. In contrast, cancers with a larger size, the distal one third of the location, well-differentiated adenocarcinoma, low depth of invasion, and high nodal metastasis were more prevalent in the late group (P < 0.05). Also, the proportion of earlier stages was increased in the late period (P<0.001). The ratios of early gastric cancers were 24.8, and 38.4% in the early and late groups, respectively (P<0.001) CONCLUSION: Our results suggest that the chronological changes of gastric cancer were closely related to the increased number of early gastric cancer patients, primarily due to the early detection of cancer. Therefore, to obtain the better outcomes from gastric cancer, an early diagnosis was essential from routine health check-ups and the well- organized establishment of a nation- and community-wide screening program and information on public health.