Gastric carcinoma. Experience from 1916 to 1949 and present concepts

T HIS report covers some aspects of the expcrienc:e of the Presbyterian Hospital with 1 5i,l cases of gastric carcinoma between tlie years 1916 arid I949 inclusive.I n addition, we 11ave knowledge 01' eighteen other cases that uii(lcrwent gastric resection between the years 1908 antl 1915, but our inforiiiation about tlicin is too incoiripletc to report at length.We !mow that 1 o ~i r ol them were lost to lollowup.'I'liirtecii died of their carcinoma or postoperative coinplications, and one surviwd lor twenty-three years after operation belore succ~uiiibirig to heart failure.We do not know liow marip Ilatients with the diagnosis ol gastric carcinoma were admitted to the hospital during those early years.We assume that all patients admitted at any time with that diagnosis coi-rectlp made, who did not undergo gastric resection, arc dead or dying, and wc k n o w what has happened to all who did 1111tlcrgo gastric resection since 1915-except one, a gypsy wlio vanished after operation from the ken ol both the doctors and the hospital bill "0 1 1 cc t 0 1's.\ are reporting in particular on the se-Icctcd group of 453 patients who underwent rcsec(ion lor gastri(; carcinoma arid who coiiilrisc 28 per cent of the hospital admissions wit11 that diagnosis, ward arid private, during tlie tliirty-i'oiir years lroiii 1915 to 1949.Males ot~triurnbercd 1em;rles aliiiost two to one.'l'wenty-seven per cent were less than 50 years old; 6-1 1x1cent, between 50 arid 69 years inclusive; antl only 9 per ccnt, 70 or iiio1-e years oltl.In the last five years, there has been an iric:rc!asc to 1,l per cent in the oldest group at clic cxpeiise ol tlie youngest, probably because o l t l age is no longer a potent deterrent to operation.Only one patient older than age 69 was siil),jccted to resection before 1931, and he died of shock the d a y of the operation.