title: [Palliative surgery in visceral medicine. Exemplified by colorectal and gastric cancer].
abstract: BACKGROUND
  The benefits of primary tumor resection in metastatic disease remains a matter of debate. Existing data are almost exclusively limited to results from retrospective analyses. Data from prospective, randomized trials are currently not available.
  
  
  OBJECTIVE
  The results from two prospective observational studies involving gastric and rectal cancer patients are presented and discussed in the context of the available literature.
  
  
  METHODS
  Based on data collected within the prospective quality assurance studies on gastric and rectal cancer conducted by the Institute for Quality Assurance in Surgery at Otto von Guericke University, Magdeburg, Germany, the long-term outcome after palliative primary tumor resection in patients with International Union Against Cancer (UICC) stage IV rectal cancer (2005-2008, n = 2046) and metastatic gastric cancer (2007-2009, n = 687) was analyzed and compared to published data.
  
  
  RESULTS
  The median survival time following palliative primary tumor resection of UICC stage IV rectal cancer in the patients analyzed was 20 months. In patients with hepatic metastases undergoing metastasectomy the median survival was 38 months. This increased to 58 months for patients with lymph node negative primary tumors. In metastatic gastric cancer patients undergoing palliative (R2) gastric resection and also patients not undergoing surgery showed a prognostic benefit from palliative chemotherapy; however, the median survival time was significantly prolonged if palliative chemotherapy was preceded by resection of the primary tumor (11 versus 7 months, p < 0.001).
  
  
  CONCLUSIONS
  Together with previously published data, the results from the two observational studies on rectal and gastric cancer presented here suggest a prognostic benefit from palliative resection of the primary tumor in metastatic disease.
authors: Institut für Qualitätssicherung in der operativen Medizin gGmbH, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, ZENIT II - Gebäude, 39120, Magdeburg, Deutschland. henryptok@aol.com.|Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, Haus 60a, 39120, Magdeburg, Deutschland. henryptok@aol.com.
authors: H
authors: H
authors: Ptok
authors: Institut für Qualitätssicherung in der operativen Medizin gGmbH, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, ZENIT II - Gebäude, 39120, Magdeburg, Deutschland.
authors: I
authors: I
authors: Gastinger
authors: Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, Haus 60a, 39120, Magdeburg, Deutschland.
authors: S
authors: S
authors: Wolff
authors: Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, Haus 60a, 39120, Magdeburg, Deutschland.
authors: C
authors: C
authors: Bruns
authors: Institut für Qualitätssicherung in der operativen Medizin gGmbH, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, ZENIT II - Gebäude, 39120, Magdeburg, Deutschland.
authors: H
authors: H
authors: Lippert
mesh_terms: D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy / Q000401:mortality; D005500:Follow-Up Studies; D017052:Hospital Mortality; D059146:Metastasectomy / Q000401:mortality; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis / Q000473:pathology; D064887:Observational Studies as Topic; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
keywords: Chemotherapy; Gastric cancer; Observational study; Palliative tumor resection; Rectal cancer