[Invasive adenocarcinoma of the stomach: prognostic factors and surgical technics].

Between 1976 and 1987, 183 patients with an invasive adenocarcinoma of the stomach were treated in the Department of Surgery of the CHUV in Lausanne. This study allows us to conclude: 1. The localisation, age, sex and the association with atrophic gastritis have no prognostic significance. 2. Histologic subtype does not influence prognosis. Eighty percent of patients with isolated cell carcinomas survived less than 2 years, as did 68% of those with intestinal cell carcinomas. 3. No patients with distant metastasis survived over 2 years: mean survival for these patients was 4.1 months. 4. Patients without distant metastasis had a survival of 24 months regardless of the type of operation and degree of stomach wall invasion. 5. Wide gastric resection seems wise to avoid local recurrence but in itself did not improve survival. 6. Wide lymph node resection should be offered to patients who can withstand the procedure by medicosurgical teams with low predictable morbidity and mortality. The improved survival seems clear for patients with stage T1N1 and T1N2 tumors. 7. These results need to be confirmed by a prospective study.