Survival in stomach cancer is improving -: Results of a nationwide population-based Swedish study

Objective To monitor for secular trends in survival among patients with stomach cancer. Summary Background Data The overall survival among patients with stomach cancer has remained stable at a low level for several decades. Methods Relative survival was estimated for all 53,862 living patients reported from 1960 to 1989 to the Swedish Cancer Registry, which is nationwide and virtually complete, with compulsory reporting of new cases of stomach cancer. Follow-up was from cancer diagnosis until death, emigration, or December 31, 1991. Results During the 1980s, statistically significant improvements were seen in the 2-month, 5-year, and 10-year relative survival of patients with stomach cancer, and in the subgroup with non-cardiac cancer. The 5-year relative survival rate increased from 13.3% (95% confidence interval [CI] 12.4 to 14.1) among patients diagnosed with noncardiac stomach cancer in 1970-1974 to 19.4% (95% CI 18.1-20.7) among those given this diagnosis in 1985-1986; the overall mean life expectancy increased from 2.2 to 3.3 years. In patients with cancer of the gastric cardia, the 5-year relative survival rate increased from 4.7% (95% CI 2.3-7.1) to 10.4% (95% CI 7.7-13.1), but the 10-year relative survival rate did not improve. The overall mean life expectancy in this group increased from 1.4 to 2.2 years. Age at diagnosis was strongly and inversely related to relative survival. Patients diagnosed at university hospitals had a moderate survival advantage. Conclusion The survival of patients with a stomach cancer diagnosis appears to be increasing. The reasons for this are probably multifactorial and are likely to include improvements in surgical and anesthesiologic management. However, the long-term prognosis of cancer of the gastric cardia remains dismal.