title: The evaluation of surgical treatment for gastric cancer patients with noncurative resection.
abstract: OBJECTIVE
  This study aims to analyze the results of treatment in a series of 233 gastric cancer patients who underwent a noncurative resection.
  
  
  METHODS
  We performed a retrospective study of patients with noncurative treatment for advanced gastric cancer who were divided into three treatment groups: total gastrectomy (TG, n=150), distal gastrectomy (DG, n=44), and nonresection (NR, bypass procedure or chemotherapy only, n=39).
  
  
  RESULTS
  In multivariate analysis, surgical treatment (TG) and an absence of chemotherapy were significant independent prognostic factors for a poor survival. In the late period, the overall survival rate was significantly lower in the TG group than in the DG group (p=0.005) and was marginally lower than in the NR group (p=0.054). The resection group had a poorer compliance for chemotherapy than the NR group, and the TG group had a poorer compliance than the DG group (p<0.01). The morbidity rate was higher in the TG group than in the DG group (p<0.05).
  
  
  CONCLUSIONS
  TG is considered to be inappropriate for the treatment of noncurative gastric cancer because of the poor prognosis, high morbidity rates, and poor compliance for chemotherapy associated with the procedure. However, noncurative DG was acceptable and postoperative chemotherapy should be used in selected patients.
authors.affiliation: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Naka
authors.forename: Makoto
authors.initials: M
authors.lastname: Iwahashi
authors.forename: Mikihito
authors.initials: M
authors.lastname: Nakamori
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ojima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Katsuda
authors.forename: Tsuji
authors.initials: T
authors.lastname: Toshiaki
authors.forename: Hayata
authors.initials: H
authors.lastname: Keiji
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents