title: [Improvements in quality of life and survival of patients with T4 gastric cancer which invaded organs after multivisceral resections through the extension of palliative gastrectomy and post-operative chemotherapy].
abstract: For patients with a locally advanced gastric cancer, palliative gastrectomy could improve local complications, such as bleeding or obstruction, but had no impact on prognosis. This study was designed to evaluate improvements in quality of life and survival of patients with T4 gastric cancer which invaded organs exhibiting bleeding or obstruction, after multivisceral resections of these organs through the extension of palliative gastrectomy and postoperative chemotherapy. Multivisceral resections were performed on 6 patients with T4 gastric cancer with local complications, such as bleeding or obstruction, at the Department of Surgery of Fujisaki hospital from 2003-2005. The sites of the organs invaded were the pancreas in five cases, and transverse colon and gallbladder in one case. The invaded organs were resected completely in five cases, and partially in one case. Surgical margins were microscopically negative in four cases. Anatomical leakage (sutured failure) occurred to none of the patients. All in all, the oral ingestion after the surgery went well. Chemotherapy (TS-1 plus CDDP) was started with 3 patients during their stay in the hospital. In addition, post-operative chemotherapy (TS-1) at the outpatient clinic was performed on 5 of the 6 patients. More than 1 year of the performance test (PS 0 or 1 in ECOG) went well for 4 patients. Two of the 4 patients could resume their work. The median survival time was more than 419.5 days. In conclusion, we consider that multivisceral resections through the extension of palliative gastrectomy and postoperative chemotherapy for patients with T4 gastric cancer could improve quality of life and prognosis.
authors.affiliation: Dept. of Surgery, Fujisaki Hospital.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Motoi
authors.initials: M
authors.lastname: Takashina
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000473:pathology; D011379:Prognosis; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*