[Indications and results of palliative gastric resection in advanced gastric carcinoma].
BACKGROUND
Gastric carcinoma is often diagnosed at UICC stage 3 b or 4. R0 resection can be achieved only in very few such cases. Even for these patients the 5-year survival rate is less than 5 %. Surgical palliation is traditionally reserved for the treatment of severe tumour complications not responding to other forms of treatment.


METHODS
We report on 21 patients who underwent palliative resection for gastric carcinoma at our institution between 2004 and 2007. Ten of these were assigned to palliative surgical treatment pre-operatively while this choice was made for 11 patients on the grounds of the intra-operative findings. We performed 17 gastrectomies, 3 proximal gastric resections and one distal gastric resection.


RESULTS
It has been shown that the patients have an improved overall survival time as compared to patients who received non-surgical treatment. The perioperative risk was reasonable when patients were carefully selected. Median survival for resected patients was 16 months. 80 % of patients were alive after 6 months and approximately 60 % of patients were alive after 12 months. The perioperative mortality was 0 % with a mean hospital stay of 12 days. All patients were discharged home with proper bowel passage and analgesia as individually required.


CONCLUSIONS
We are convinced that palliative gastric resection provides a pronounced survival benefit over any other palliative treatment options. Patients also have an improved quality of life.
Dittmar
Y
Y
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Universitätsklinikum Jena, Germany.
Voigt
R
R
Heise
M
M
Rabsch
A
A
Jandt
K
K
Settmacher
U
U
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015992:Body Mass Index; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007813:Laparotomy; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010166:Palliative Care; D018579:Patient Selection; D011182:Postoperative Care; D011788:Quality of Life; D013270:Stomach / Q000469:parasitology; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil