Palliative surgery in management of advanced carcinoma stomach and its outcome

Abstract

Background:Gastric cancer is the second leading cause of death from malignant disease World-wide and most frequently discovered in advanced stages. The incidence of gastric cancer in India is low compared to developed countries. But in India southern and northeast area more number of cases was diagnosed. More cases of cancer stomach are diagnosed in the early stages in Japan due to effective screening programme. Lack of such screening programme, ignorance about the disease and lack of awareness of warning signs of cancer lead to the detection of many cases in the advanced stage of gastric cancer. Where palliation is the mainstay of treatment. We discussed the different methods of palliative surgery and its outcome in this paper. Methods: This is a prospective study over 5 years February 2011 - 2016 January including 6 months follow up. 104 advanced carcinoma stomach patients were included in this study. To evaluate role of palliative surgery in advanced gastric cancer we analyse the data in the basis of presentation of disease, sex distribution, type of palliative surgery, relive of symptoms, preventions of complications, post-operative mortality morbidity, and overall survival.Results:In our study mean age of presentation is 58 years. Most common affected are male. Stage III disease are more common. Immediate post-operative mortality is 4 patients 7.14% comparable to the non-resection group 1 patients (2.63%). Symptoms relived 46 patients in resection group (82.14%), in non-resection group it is 16 (42.1%). Overall survival is (6 moths - 1 years) 19 (33.9%) patients, and in non-resection group it is only 2 (5.26%) patients. Median survival rate is 10 months.Conclusions:Palliative resection should be carried out for betterment of quality of life where it is possible. Relief from symptoms and complications can be achieved by resection of tumour mass in advanced carcinoma stomach.