title: Palliative surgery for advanced stage (stage IV) gastric adenocarcinoma.
abstract: OBJECTIVE
  The factors that effect resectability, major morbidity, early mortality, and survival in advanced stage gastric adenocarcinoma patients are evaluated.
  
  
  METHODS
  Records of 74 patients that underwent surgery for stage IV gastric adenocarcinoma in the Third Surgical Clinic of Izmir Atatürk Training Hospital between January 1997 and January 2004 were reviewed retrospectively. Two groups (the patients with resectable disease and those with unresectable disease) were compared with regard to age, gender, primary complaint, symptoms, site of the tumor, involvement of adjacent organs, lymph node involvement, distant metastases, differentiation of tumor, surgical procedure, perioperative blood transfusions, and postoperative hospital stay.
  
  
  RESULTS
  Mean age of the 74 patients was 58.4 years. Forty-five cases (60.8%) were considered as unresectable and 29 (39.2%) patients underwent a palliative resection. There was a significant relation between resectability and site of the tumor, and severity of invasion. As the number of perioperative blood transfusions increased, morbidity and mortality increased significantly. Although early mortality was high in the palliative resection group, survival (mean 10.4 months, longest 25 months) was better compared to that of the unresectable gastric cancer group (mean 3.5 months, longest eight months).
  
  
  CONCLUSIONS
  A palliative gastric surgery may be applied to improve prognosis of advanced gastric cancer patients, even at the presence of peritoneal dissemination, hepatic metastases, N3 lymph node involvement, adjacent organ invasion, or poor differentiation of the tumor.
authors.affiliation: Third Surgical Clinic of Atatürk Training Hospital, izmir, Turkey.
authors.forename: Okay
authors.initials: O
authors.lastname: Nazli
authors.forename: Ismail
authors.initials: I
authors.lastname: Yaman
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Tansuğ
authors.forename: Ali Serdar
authors.initials: AS
authors.lastname: Işgüder
authors.forename: Ali Dogan
authors.initials: AD
authors.lastname: Bozdag
authors.forename: Hakan
authors.initials: H
authors.lastname: Bölükbaşi
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*