title: Survival benefit of palliative gastrectomy in gastric cancer patients with peritoneal metastasis.
abstract: BACKGROUND
  The survival benefit of palliative gastrectomy in patients with peritoneal metastasis as a single incurable factor remains unclear.
  
  
  METHODS
  A total of 148 gastric cancer patients with peritoneal metastasis underwent gastrectomy or chemotherapy at the Shizuoka Cancer Center between September 2002 and December 2008 and were included in this study. The effects of gastrectomy and chemotherapy on their long-term outcome were investigated. Multivariate analysis was also performed to identify independent prognostic factors.
  
  
  RESULTS
  Gastrectomy was performed in 82 patients and subsequent chemotherapy was administered to 55. Chemotherapy was selected as an initial treatment for 66 patients. Median survival time (MST) was identical between patients with and without gastrectomy (13.1 vs. 12.0 months; P = 0.410). Conversely, MST was significantly longer in patients who received chemotherapy (13.7 months) than those who did not (7.1 months; P = 0.048). According to the results of multivariate analysis, chemotherapy (hazards ratio [HR] = 0.476; 95 % CI = 0.288-0.787) was selected as an independent prognostic factor, while gastrectomy was not.
  
  
  CONCLUSIONS
  The results of the present study did not show a survival benefit of palliative gastrectomy in selected patients with peritoneal metastasis. Instead, chemotherapy has to be considered as an initial treatment for these patients.
authors: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan. m.tokunaga@scchr.jp
authors: Masanori
authors: M
authors: Tokunaga
authors: Masanori
authors: M
authors: Terashima
authors: Yutaka
authors: Y
authors: Tanizawa
authors: Etsuro
authors: E
authors: Bando
authors: Taiichi
authors: T
authors: Kawamura
authors: Hirofumi
authors: H
authors: Yasui
authors: Narikazu
authors: N
authors: Boku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult