Impact of palliative gastrectomy in patients with incurable advanced gastric cancer.
BACKGROUND
The efficacy of palliative gastrectomy for incurable advanced gastric cancer remains debatable.


METHODS
The study group comprised a series of 164 patients who had undergone palliative gastrectomy. Survival and prognostic factors were evaluated by univariate and multivariate analyses.


RESULTS
The median survival time was 9 months. Univariate analysis identified the following as factors that adversely affected survival: larger and deeper undifferentiated tumors; peritoneal, hematogenous, or remaining lymph-node metastasis; a large number of non-curative factors; less extensive lymph-node dissection; and an absence of chemotherapy. The Cox proportional regression hazard model recognized histological type, hematogenous metastasis, peritoneal metastasis and chemotherapy as independent factors. Moreover, the number of non-curative factors independently affected the disease-specific survival. In patients with a single non-curative factor, histological type and adjuvant chemotherapy were independent prognostic factors.


CONCLUSIONS
A randomized controlled study should be conducted in advanced gastric cancer patients with a single non-curative factor to confirm the usefulness of palliative gastrectomy followed by chemotherapy shown here.
Kunisaki
Chikara
C
Department of Surgery, Gastroenterological Center, Yokohama City University, Minami-ku, Yokohama, Japan. s0714@med.yokohama-cu.ac.jp
Makino
Hirochika
H
Takagawa
Ryo
R
Oshima
Takashi
T
Nagano
Yasuhiko
Y
Fujii
Shoichi
S
Otsuka
Yuichi
Y
Akiyama
Hirotoshi
H
Ono
Hidetaka A
HA
Kosaka
Takashi
T
Ichikawa
Yasushi
Y
Shimada
Hiroshi
H
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D015996:Survival Rate