Postoperative survival in advanced gastric cancer

We assessed the postoperative survival in 143 consecutive patients with advanced gastric cancer. Police databases represented a very powerful research tool and allowed a response rate of 94.4%. Mean postoperative survival was 10 months - irrespective of stage - with 52.6% and 30.3% survival rates at 6 months and 12 months respectively. Long-term survival cannot be really commented with only 11 % of patients alive after 24 months. Statistical analysis demonstrated a lack of prognostic significance of tumour stage (except for stage 4), as well as lymph node spread. No real benefit in survival was evident for palliative resection in locally advanced gastric cancer. We were not able to prove a significant benefit of more extensive (D2) lymph node dissection. The only proven prognostic factor in our study appeared to be the oncologic quality of resection. Survival was significantly longer in R1 (no macroscopic residual tumor) cases vs. R2 macroscopic residual tumour cases (p<0.05), but no difference could be found between R2 (macroscopic residual tumor) cases and non-resectable cases.