title: The value of palliative gastrectomy in gastric cancer with distant metastasis.
abstract: OBJECTIVE
  The purpose of this study was to examine the value of surgical resection and to find prognostic factors for metastatic gastric cancer.
  
  
  METHODS
  Clinicopathological data of 257 cM1 gastric cancer patients who underwent an operation at Seoul National University Hospital from January 1999 to December 2004 were reviewed. Patients were grouped into the resection (RS, n=165) and nonresection groups (NR, n=92). To evaluate whether there was any selection bias, patients were stratified according to chemotherapy and preoperative CT findings were compared.
  
  
  RESULTS
  There were no significant differences in clinicopathologic features and preoperative CT findings between the RS and NR groups. For chemotherapy, the RS group had a survival benefit (median survival; 12.7 vs. 11.2 months, p=0.0107). In the subanalysis, there was a survival benefit to the RS group when metastasis was confined to one site (14 vs. 9.7 months, p=0.04). In patients with no chemotherapy, the RS group had no benefit (p=0.151). In univariate and multivariate analyses, resection (p=0.001), chemotherapy (p<0.001), the number of organs with metastatic lesions (p=0.003), and elective operation (p<0.001) were significant prognostic factors.
  
  
  CONCLUSIONS
  This retrospective study suggests that surgical resection in metastatic gastric cancer may improve survival when combined with chemotherapy, especially when metastasis is confined to one site.
authors: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Ye Rim
authors: YR
authors: Chang
authors: Dong Seok
authors: DS
authors: Han
authors: Seong-Ho
authors: SH
authors: Kong
authors: Hyuk-Joon
authors: HJ
authors: Lee
authors: Se Hyung
authors: SH
authors: Kim
authors: Woo Ho
authors: WH
authors: Kim
authors: Han-Kwang
authors: HK
authors: Yang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000556:secondary*; D010166:Palliative Care; D011379:Prognosis; D012366:RNA, Transfer, Val; D011859:Radiography; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*
chemical_list: D012366:RNA, Transfer, Val; D002945:Cisplatin; D005472:Fluorouracil