Palliative gastrectomy and chemotherapy for stage IV gastric cancer.
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.
Lin
Sheng-Zhang
SZ
Department of General Surgery, Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, China. wzf2lsz@163.com
Tong
Hong-Fei
HF
You
Tao
T
Yu
Yao-Jun
YJ
Wu
Wei-Jun
WJ
Chen
Cong
C
Zhang
Wei
W
Ye
Bing
B
Li
Chun-Ming
CM
Zhen
Zhi-Qiang
ZQ
Xu
Jia-Rong
JR
Zhou
Jun-Liang
JL
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