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Palliative gastrectomy for advanced gastric cancer
K Hanazaki1, H Sodeyama, Y Mochizuki
12nd Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. hanayan@hsp.md.shinshu-u.ac.jp
Hepato-Gastroenterology
|March 28, 2001
Summary
Palliative gastrectomy improved survival for advanced gastric cancer patients, especially those with distant metastasis but not synchronous liver metastasis. This surgical approach offers a better prognosis compared to unresectable operations.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Palliative gastrectomy for advanced gastric cancer (AGC) is considered for symptom relief but its prognostic impact is under-explored.
- Limited data exists on the clinical significance and survival outcomes associated with palliative gastrectomy in AGC.
Purpose of the Study:
- To compare the clinical significance and prognosis of palliative gastrectomy (PG) versus unresectable operations (UO) in patients with advanced gastric cancer.
- To evaluate the impact of palliative gastrectomy on survival rates in different stages and metastatic patterns of AGC.
Main Methods:
- Retrospective comparative study involving 84 patients undergoing PG and 100 patients undergoing UO for AGC.
- Analysis of clinicopathological features, survival times, and survival rates between the two groups.
Main Results:
- The PG group had significantly lower rates of serosal invasion, peritoneal dissemination, and distant metastases compared to the UO group.
- Median survival was significantly longer in the PG group (20.6 months) than in the UO group (5.7 months).
- In stage IVb patients, PG showed longer median survival (10.2 months vs. 5.0 months), but this was not observed in patients with synchronous liver metastasis (8.4 months vs. 4.6 months).
Conclusions:
- Palliative gastrectomy may improve prognosis in advanced gastric cancer patients with peritoneal dissemination and/or distant lymph node metastasis, even in stage IVb.
- Palliative gastrectomy might be unfavorable for survival in patients with synchronous liver metastasis.
- The study highlights the selective benefit of palliative gastrectomy in specific advanced gastric cancer scenarios.