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Survival from cancer of the stomach in England and Wales up to 2001

British Journal of Cancer
Nature Publishing Group
Publication Date
DOI: 10.1038/sj.bjc.6604575
  • Clinical Commentary
  • Medicine


Clinical Commentary Survival from cancer of the stomach in England and Wales up to 2001 S Rao1 and D Cunningham*,1 1Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK British Journal of Cancer (2008) 99, S19 – S20. doi:10.1038/sj.bjc.6604575 Published online 23 September 2008 & 2008 Cancer Research UK � � � � � � � � � � � � � � � � � Gastric cancer is characterised by nonspecific symptoms and thus patients often present at an advanced stage. Patients may present with weight loss, anorexia, epigastric discomfort, and more infrequently, early satiety or vomiting of blood. Diagnosis is by endoscopy and biopsy and CT scans of the chest, abdomen and pelvis are required to stage the disease. Endoscopic ultrasound (EUS) allows direct visualisation of the gastric mucosa and has an accuracy of up to 90% for T staging and 75% for N staging, which is superior to CT scan and was widely implemented towards the late 1990s (Dittler and Siewert, 1993; Matsumoto et al, 2000). Staging laparoscopy has become an accepted pretreatment evaluation for patients with localised disease for detecting occult metastatic disease not visible on CT scan. This probably had the greatest impact on staging in the 1990s when helical CT scans were not routinely employed and detection rates of occult metastases were up to 37% in some studies (Lowy et al, 1996; Asencio et al, 1997; Burke et al, 1997). Surgical resection was the cornerstone of treatment for patients with localised gastric cancer during this period and many studies evaluating surgical techniques were conducted. Several studies demonstrated that perioperative mortality for gastrectomy was inversely related to the institutional gastrectomy volume (Birk- meyer et al, 2002; Hannan et al, 2002). This has led to the centralisation of care for gastric cancer with surgery generally performed at larger centres by specialist surgeons. Adjuvant therapy was not routine practice at this time, as the supporting ev

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