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Significance of palliative gastrectomy for late‐stage gastric cancer patients
Author(s) -
Chen Shi,
Li YuanFang,
Feng XingYu,
Zhou ZhiWei,
Yuan XiuHong,
Chen YingBo
Publication year - 2012
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/jso.23158
Subject(s) - medicine , gastrectomy , cancer , lymph node , metastasis , stage (stratigraphy) , palliative care , surgery , gastroenterology , oncology , paleontology , nursing , biology
Purpose To investigate the significance of palliative gastrectomy for different types of metastatic gastric cancer patients displaying peritoneal dissemination, hepatic metastasis, distant lymph node metastasis occurring locally during late‐stage disease, and multi‐organ metastases. Methods We performed a retrospective study of 862 patients who were histologically diagnosed as late‐stage gastric cancer who could not undergo radical surgery at the Sun Yat‐sen University Cancer Center between January 1993 and December 2008. The follow‐up lasted until December 2010. Chi‐square tests and Kaplan–Meier methods were employed to compare the adverse events and prognoses. Results In the peritoneal dissemination and multi‐organ metastases groups, palliative gastrectomy has no survival benefit ( P = 0.705, 0.331, respectively). In the patients with distant lymph‐node metastases, liver metastasis and locally late‐stage gastric cancer patients, palliative gastrectomy was a prognostic factor ( P < 0.001, P < 0.001, P = 0.010, respectively). Multivariable analysis demonstrated that palliative gastrectomy was an independent prognostic factor for distant lymph‐node metastases, liver metastasis, and local late‐stage gastric cancer patients. Palliative gastrectomy combined with hepatectomy proved to be an independent prognostic factor to improve the overall survival of patients with liver metastases who underwent palliative gastrectomy ( P = 0.008). Conclusion For late‐stage gastric cancer patients, palliative gastrectomy should be considered for locally late‐stage, distant lymph node metastasis, and resectable liver metastasis patients. Especially among patients with liver metastasis, transfer medicine is essential for potentially curable patients to obtain access to radical surgery to improve the prognosis. J. Surg. Oncol. 2012; 106:862–871. © 2012 Wiley Periodicals, Inc.