Palliative total gastrectomy and esophagogastrectomy. A reevaluation

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Gastric cancer treatment evolved significantly between 1941 and 1981.
• Surgical interventions ranged from curative resections to palliative measures and exploration.

Observation:

• 1887 gastric cancer patients were analyzed.
• 151 curative and 45 palliative gastrectomies were performed.
• 21 patients underwent exploration or bypass.

Findings:

• Survival rates were highest for curative resection, followed by palliative resection, and then exploration/bypass (P ≤ 0.0006).
• Operative mortality significantly decreased in curative resection patients from 1970-1981 compared to 1941-1969.
• Operative mortality was significantly lower in curative resection than palliative resection groups (1970-1981, P ≤ 0.01).
• Five-year survival significantly improved in the curative resection group over the two time intervals (P ≤ 0.03).

Implications:

• Curative gastrectomy offers superior survival outcomes for gastric cancer patients.
• Improvements in surgical techniques and patient selection have reduced operative mortality and enhanced survival.
• Palliative resection and exploration remain options, but with lower survival expectations.