[Changes in clinicopathological features and survival after surgical resection for gastric cancer over a 20-year period at a single institution].

Objective: To investigate changes in clinicopathological features and survival of patients with gastrectomy at a single institution in China.

Methods: From January 1990 to December 2009, clinicopathological data of 2518 cases of gastric cancer patients who underwent surgical resection in the Sun Yat-sen University Cancer Center were analyzed retrospectively. The overall survival rate was determined using Kaplan-Meier method and log-rank test was used to determine significance. The prognosis was analyzed using univariate analysis and multivariate analysis by Cox proportional hazards model. Clinical features, pathological findings and survival differences were compared in this cohort between two consecutive periods(1990-1999 and 2000-2009).

Results: The 5-year survival rates for the whole cohort and those undergoing radical resection was 48.1% and 53.7%, respectively. In the first period, the 5-year survival rate for the whole cohort and for patients undergoing radical resection was 40.1% and 45.7%. In the second period, the 5-year survival rates for whole cohort and for patients undergoing radical resection was 51.5% and 57.1%, respectively. For those who underwent radical resection, the mean number of lymph node dissection was significantly higher in the recent period (20.1±8.3 vs. 9.5±6.0, P<0.01). On multivariate analysis by means of the Cox proportional hazard model, age, location, tumor size, histological type, radical resection, lymphatic/venous invasion, depth of invasion, nodal status, number of retrieved lymph nodes, and treatment period were independent factors (P<0.05). The constitution, number of retrieved lymph nodes, and survival rate were all improved between the two intervals (P<0.05).

Conclusion: The overall survival rate has gradually increased in gastric cancer patients over the past 20 years.