title: Outcome of palliative total gastrectomy for stage IV proximal gastric cancer.
abstract: BACKGROUND
  A few studies have investigated the outcome of palliative total gastrectomy (PTG) in stage IV proximal gastric cancer. In this study, we tried to summarize the outcome of PTG in stage IV proximal gastric cancer.
  
  
  METHODS
  Between January 1991 and January 2005, complete clinical data of 197 patients with stage IV proximal gastric cancer undergoing PTG, 642 patients undergoing curative total gastrectomy (CTG), 152 nonsurgical patients, 102 patients undergoing explorative laparotomy, and 78 patients undergoing jejunostomy were enrolled in this study. Survival rates, median survival, complication rates, and mortality were analyzed.
  
  
  RESULTS
  The 1-year, 3-year, and 5-year survival rates were 61.3%, 8.9%, and 6.4% in the PTG group, respectively, and 92.3%, 58.5%, and 48.9% in the CTG group, respectively (P < .05). The median survival periods in the PTG, no surgery, laparotomy, and jejunostomy groups were 16.4, 5.5, 4.7, and 5.8 months, respectively. The median survival in the PTG group was significantly longer than that in the other 3 groups (P < .05). The postoperative complication rate and mortality rate were, respectively, 24.3% and 3.0% in the PTG group and 13.5% and 2.3% in the CTG group (P > .05).
  
  
  CONCLUSIONS
  PTG for stage IV proximal gastric cancer when compared with no surgery, laparotomy, and jejunostomy is associated with prolonged survival time and improved quality of life. However, despite the feasibility and safety of PTG, patients with stage IV proximal gastric cancer who are suitable for this treatment should be selected, and thoughtful preparation should be made in the perioperative period.
authors: Department of Surgical Oncology, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China. dvd8998@gmail.com
authors: Jian-Zhong
authors: JZ
authors: Zhang
authors: Hui-Shan
authors: HS
authors: Lu
authors: Chang-Ming
authors: CM
authors: Huang
authors: Xing-Yuan
authors: XY
authors: Wu
authors: Chuang
authors: C
authors: Wang
authors: Guo-Xian
authors: GX
authors: Guan
authors: Jian-Wei
authors: JW
authors: Zhen
authors: He-Guang
authors: HG
authors: Huang
authors: Xian-Fu
authors: XF
authors: Zhang