title: Palliative gastrectomy and chemotherapy for stage IV gastric cancer.
abstract: OBJECTIVE
  To investigate the value of palliative gastrectomy and chemotherapy in a large series of patients with stage IV gastric cancer.
  
  
  METHODS
  A total of 389 patients were identified in survival analysis. Among which, 183 cases received palliative gastrectomy (PG) and 206 cases received unresectable operation, 184 cases received palliative chemotherapy (PC) and 205 cases did not receive chemotherapy. The survival advantages of patients, based on treatments modality, were also analyzed in patients with liver metastasis, peritoneal dissemination and lymph node metastasis.
  
  
  RESULTS
  The 1-year, 3-year, 5-year survival rate of those patients who were treated with PG + PC were 85.7% (96/112), 32.1% (36/112), and 8.9% (10/112), which were far better than those who were not. For those patients with liver metastasis, peritoneal dissemination, and/or N3 lymph node metastasis, survival advantages were also present if treated with this multimodality approach.
  
  
  CONCLUSIONS
  The survival time and palliative duration were significantly longer in patients after PG than after non-resection operations. Postoperative chemotherapy prolonged the survival time of patients after palliative surgery. PG combined with adjuvant chemotherapy may improve survival in patients with stage IV gastric cancer, even with liver metastasis, peritoneal dissemination, and lymph node metastasis.
authors.affiliation: Department of General Surgery, Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, China. wzf2lsz@163.com
authors.forename: Sheng-Zhang
authors.initials: SZ
authors.lastname: Lin
authors.forename: Hong-Fei
authors.initials: HF
authors.lastname: Tong
authors.forename: Tao
authors.initials: T
authors.lastname: You
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Yu
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Wu
authors.forename: Cong
authors.initials: C
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Bing
authors.initials: B
authors.lastname: Ye
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Li
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Zhen
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Xu
authors.forename: Jun-Liang
authors.initials: JL
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors