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Gastric malignancy: resection for palliation.

G A Ekbom, J J Gleysteen

    Surgery
    |October 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Curative resection for gastric cancer significantly improves long-term survival and palliation compared to palliative resection or gastrojejunostomy. While complications may increase, extending resection for curative intent is beneficial for prolonging patient survival.

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    Area of Science:

    • Oncology
    • Surgical Gastroenterology
    • Gastrointestinal Oncology

    Background:

    • Gastric malignancy treatment historically involved various surgical approaches.
    • Comparing outcomes of different surgical interventions is crucial for optimizing patient care.

    Purpose of the Study:

    • To compare the efficacy of curative resection (CR), palliative resection (PR), and gastrojejunostomy (GJ) in managing gastric adenocarcinoma.
    • To evaluate differences in mortality, complications, symptom palliation, and survival rates among the surgical groups.

    Main Methods:

    • Retrospective review of 144 patients with gastric malignancy (98% adenocarcinoma) treated between 1957 and 1978.
    • Patients underwent CR, PR, or GJ based on intraoperative assessment.
    • Data collected included extent of resection, mortality, complications, diet, symptom palliation, and survival.

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    Main Results:

    • Gastrojejunostomy (GJ) had a 25% operative mortality and 20% complication rate, with limited symptom palliation (5.9 months) and no 1-year survivors.
    • Palliative resection (PR) showed improved symptom relief (14.6 months) and 7% 3-year survival.
    • Curative resection (CR) offered the best palliation (47.6 months) and significantly improved 3-year survival (38%) compared to PR and GJ.

    Conclusions:

    • Curative resection significantly enhances long-term survival and symptom palliation in gastric cancer patients.
    • While extended resection for curative intent carries a risk of increased complications, it is justified by improved survival outcomes.
    • Resection of the primary tumor is superior to bypass procedures for both palliation quality and duration.