title: Noncurative Resection for Gastric Cancer Patients: Who Could Benefit? : Determining Prognostic Factors for Patient Selection.
abstract: BACKGROUND
  Resections have long been recommended for patients with incurable gastric cancer. However, high morbidity rates and more efficient chemotherapy regimens have demanded more accurate patient selection. The aim of this study was to analyze the results of gastric cancer patients treated with noncurative resection in a single cancer center.
  
  
  METHODS
  Medical charts of patients treated with a noncurative resection between January 1988 and December 2012 were analyzed. Individuals who had M1 disease were included, along with those with no metastasis but who had an R2 resection. Morbidity, mortality, and survival prognostic factors were analyzed.
  
  
  RESULTS
  In the period, 192 patients were resected, 159 with previously diagnosed metastatic disease and the other 33 having resection with macroscopic residual disease (R2). A distal gastrectomy was performed in 117 patients and a total resection in 75, with a more limited lymph node dissection in 70 % of cases. A multivisceral resection was deemed necessary in 42 individuals (21.9 %). Overall morbidity was 26.6 % and 60-day mortality was 6.8 %. Splenectomy was the only independent prognostic factor for higher morbidity. Median survival was 10 months, and younger age, distal resection, and chemotherapy were independent prognostic factors for survival. A prognostic score obtained from these factors identified a 20-month median survival in patients with these favorable characteristics.
  
  
  CONCLUSIONS
  Noncurative surgery may be considered in selected gastric cancer patients as long as it has low morbidity and allows the realization of chemotherapy.
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. coimbra.felipe@uol.com.br.
authors.forename: Felipe J F
authors.initials: FJ
authors.lastname: Coimbra
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. dr.wilsoncosta@gmail.com.
authors.forename: Wilson Luiz
authors.initials: WL
authors.lastname: da Costa
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. hsalvadorcr@gmail.com.
authors.forename: Héber S C
authors.initials: HS
authors.lastname: Ribeiro
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. dr.aldiniz@gmail.com.
authors.forename: Alessandro L
authors.initials: AL
authors.lastname: Diniz
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. andreluisgodoy@yahoo.com.br.
authors.forename: André Luís
authors.initials: AL
authors.lastname: de Godoy
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. dr.igorfarias@gmail.com.
authors.forename: Igor Correia
authors.initials: IC
authors.lastname: de Farias
authors.affiliation: Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil. acury@me.com.
authors.forename: Antonio Moris Cury
authors.initials: AM
authors.lastname: Filho
authors.affiliation: Department of Clinical Oncology, A. C. Camargo Cancer Center, São Paulo, Brazil. marcello.fanelli@hcancer.org.br.
authors.forename: Marcello Ferretti
authors.initials: MF
authors.lastname: Fanelli
authors.affiliation: Department of Surgical Pathology, A. C. Camargo Cancer Center, São Paulo, Brazil. mariadirlei@gmail.com.
authors.forename: Maria Dirlei F S
authors.initials: MD
authors.lastname: Begnami
authors.affiliation: Department of Surgical Pathology, A. C. Camargo Cancer Center, São Paulo, Brazil. fasoares@accamargo.org.br.
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis*; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult