Impact of palliative gastrectomy in patients with incurable advanced gastric cancer.

BACKGROUND

The efficacy of palliative gastrectomy for incurable advanced gastric cancer remains debatable.

PATIENTS AND METHODS

The study group comprised a series of 164 patients who had undergone palliative gastrectomy. Survival and prognostic factors were evaluated by univariate and multivariate analyses.

RESULTS

The median survival time was 9 months. Univariate analysis identified the following as factors that adversely affected survival: larger and deeper undifferentiated tumors; peritoneal, hematogenous, or remaining lymph-node metastasis; a large number of non-curative factors; less extensive lymph-node dissection; and an absence of chemotherapy. The Cox proportional regression hazard model recognized histological type, hematogenous metastasis, peritoneal metastasis and chemotherapy as independent factors. Moreover, the number of non-curative factors independently affected the disease-specific survival. In patients with a single non-curative factor, histological type and adjuvant chemotherapy were independent prognostic factors.

CONCLUSION

A randomized controlled study should be conducted in advanced gastric cancer patients with a single non-curative factor to confirm the usefulness of palliative gastrectomy followed by chemotherapy shown here.