Is palliative resection necessary for gastric carcinoma patients?
OBJECTIVE
The benefit of palliative resection for gastric carcinoma patients remains controversial. We thus evaluated the survival benefit of palliative resection in advanced gastric carcinoma patients.


METHODS
We reviewed the hospital records of 466 gastric carcinoma patients who had palliative resection and compared the clinicopathologic findings to those of patients who underwent a bypass or exploration from 1986 to 2000.


RESULTS
Cox's proportional hazard regression model revealed only one independent statistically significant prognostic parameter, the presence of peritoneal dissemination (risk ratio, 0.739; 95% confidence interval, 0.564-0.967; P < 0.05). The 5-year survival rate of patients who had palliative resection was higher than that of patients who did not (7.03 vs 0%, P < 0.001). When the 5-year survival rates of patients with peritoneal dissemination were examined, the rate was higher for those who underwent resection (4.43 vs 0%, P < 0.001).


CONCLUSIONS
The results highlight the improved survivorship of gastric carcinoma patients with palliative resection compared to those who did not undergo the procedure. Although curative resection is not possible in this group of patients, we recommend performing resection aimed at palliation.
Kim
Dong Yi
DY
Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, 8, Hakdong, Dongku, Gwangju 501-757, South Korea. dockim@jnu.ac.kr
Joo
Jae Kyoon
JK
Park
Young Kyu
YK
Ryu
Seong Yeob
SY
Kim
Young Jin
YJ
Kim
Shin Kon
SK
Lee
Jae Hyuk
JH
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007723:Korea; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*