Abstract
BackgroundSalvage chemotherapy is the mainstay of treatment for metastatic gastric cancer (mGC). This study aimed to clarify the effects of palliative gastrectomy (PG) and identify prognostic factors in mGC patients undergoing PG.MethodsThis was a retrospective review of 333 mGC patients receiving PG or a non-resection procedure (NR) between 2000 and 2010. Clinicopathological factors affecting the prognosis of these patients were collected prospectively and analyzed.ResultsOne hundred and ninety-three patients underwent PG and 140 NR. The clinicopathological characteristics were comparable between the two groups except for metastatic pattern. There were no significant differences in postoperative morbidity and mortality between the two groups. The PG group had a significantly longer median overall survival compared with the NR group (7.7 months vs. 4.9 months). In the PG group, age ≤58 years, preoperative albumin level >3 g/dL, ratio of metastatic to examined lymph nodes ≤0.58, and administration of chemotherapy were independent prognostic factors in multivariate analysis.ConclusionsPatients undergoing PG had better outcomes than those undergoing NR. Among the patients undergoing resection, age ≤58 years, a better preoperative nutritional status, less nodal involvement and postoperative chemotherapy independently affected patient survival.
Highlights
Salvage chemotherapy is the mainstay of treatment for metastatic gastric cancer
The palliative gastrectomy (PG) group had a higher percentage of patients who survived for more than 12 months compared with the non-resection procedure (NR) group. (29.5% vs. 15.7%; P =0.005)
The patients treated with PG and postoperative salvage chemotherapy had a markedly longer median overall survival time than those receiving PG or salvage chemotherapy alone, or the NR group without chemotherapy (P
Summary
Salvage chemotherapy is the mainstay of treatment for metastatic gastric cancer (mGC). This study aimed to clarify the effects of palliative gastrectomy (PG) and identify prognostic factors in mGC patients undergoing PG. Surgical resection with adequate lymphadenectomy provides the best chance of a cure [2, 3]. Most patients present with locally advanced or metastatic disease at the time of diagnosis, with a 5-year survival rate of around 10% [4, 5]. Patients with inoperable or metastatic disease usually die within 12 months with or without salvage chemotherapy [6, 7]. Patients with tumor-associated symptoms including dysphagia, gastric outlet obstruction, bleeding or gastric perforation may need a surgical intervention.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
