title: Impact of palliative gastrectomy in patients with incurable advanced gastric cancer.
abstract: 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.
authors.affiliation: Department of Surgery, Gastroenterological Center, Yokohama City University, Minami-ku, Yokohama, Japan. s0714@med.yokohama-cu.ac.jp
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hirochika
authors.initials: H
authors.lastname: Makino
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hidetaka A
authors.initials: HA
authors.lastname: Ono
authors.forename: Takashi
authors.initials: T
authors.lastname: Kosaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: 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