Premium
Therapeutic significance of palliative operations for gastric cancer for survival and quality of life
Author(s) -
Ouchi Kiyoaki,
Sugawara Tohoru,
Ono Hidemaro,
Fujiya Tsuneaki,
Kamiyama Yasuhiko,
Kakugawa Yoichiro,
Mikuni Junichi,
Yamanami Hideaki
Publication year - 1998
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199809)69:1<41::aid-jso8>3.0.co;2-k
Subject(s) - medicine , cancer , quality of life (healthcare) , intensive care medicine , palliative care , cancer survival , overall survival , quality (philosophy) , oncology , surgery , nursing , philosophy , epistemology
Background and Objectives: There have been few reports on the objective assessment of quality of life (QOL) in patients with gastric cancer following palliative operations. The benefit of a palliative operation for survival and QOL of patients with gastric cancer is not clear. Methods Survival and hospital‐free survival (HFS), which is considered to be one objective indicator of QOL, were studied in 95 patients undergoing palliative operations for gastric cancer. Univariate and multivariate analyses were used to determine the clinicopathologic factors potentially related to survival of patients. Results In univariate analysis, palliative gastrectomy and absence of peritoneal dissemination were significantly correlated with better survival. The significance of palliative gastrectomy for survival was, therefore, evaluated for various degrees of peritoneal dissemination: P 0 , no dissemination; P 1 , metastasis to the adjacent peritoneum; P 2 , a few scattered metastases to the distant peritoneum; and P 3 , numerous metastases. Survival and achievement of HFS for 3 months or longer were higher following palliative gastrectomy than gastrojejunostomy. Among gastrectomies, however, total gastrectomy performed in patients with P 2 or P 3 showed a poorer outcome for survival and HFS than total gastrectomy performed with P 0 or P 1 and distal gastrectomy. Conclusions As a palliative measure, gastrojejunostomy and total gastrectomy performed with P 2 or P 3 peritoneal dissemination had no beneficial effect on the prolongation of survival or improvement of QOL of patients with gastric cancer. J. Surg. Oncol. 1998;69:41–44. © 1998 Wiley‐Liss, Inc.