Abstract
Background
Indications for palliative surgery in gastric carcinoma (GC) are controversial. Our aim was to describe the results of palliative surgery in GC in terms of operative morbidity and survival.
Methods
We conducted a retrospective cohort study of patients with GC, who were divided into three groups: resection with microscopic residual disease (R1), palliative resection with macroscopic residual disease (R2), and gastrojejunostomy. Comparisons were tested with analysis of variance (ANOVA) or χ2 test, and the Kaplan-Meier method was used for survival analysis.
Results
One hundred and thirty-two patients were included in the study: 21 had R1, 71 had R2, and 40 had gastrojejunostomy. Surgical morbidity was recorded in 4 patients (19%), 23 patients (32.4%), and 1 patient (2.5%) in each of the three groups, respectively (P = 0.001). Operative mortality occurred in 6 patients (8.5%) from the R2 group and in 1 (2.5%) patient from the gastrojejunostomy group (P = 0.406). Median survivals of the R1, R2, and gastrojejunostomy groups were 22.8 months (95% confidence interval [CI], 16.4–29.3), 12.4 (95% CI, 9.01–15.8) months, and 6.4 months (95% CI, 0–14.6), respectively (P = 0.078)
Conclusion
R1 resections and gastrojejunostomy were associated with low surgical morbidity and mortality, unlike R2 resection; in this group, surgical morbidity and mortality was high. Therefore, the benefit of palliative resection in the presence of extensive residual disease should be balanced against the risk of surgical morbidity.
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References
BJ Dicken DL Bigam C Cass JR Mackey AA Joy SM Hamilton (2005) ArticleTitleGastric adenocarcinoma: review and considerations for future directions Ann Surg 241 27–39 Occurrence Handle15621988
JL Munson R O'Mahony (2005) ArticleTitleRadical gastrectomy for cancer of the stomach Surg Clin North Am 85 1021–32 Occurrence Handle16139034 Occurrence Handle10.1016/j.suc.2005.05.008
LF Oñate-Ocaña V Aiello-Crocifoglio R Mondragón-Sánchez JM Ruiz Molina D Gallardo-Rincón (1999) ArticleTitlePrognostic factors in 793 cases of gastric cancer in an oncologic referral center Rev Gastroenterol Mex 64 114–21 Occurrence Handle10532138
TJ Miner DP Jaques MS Karpeh MF Brennan (2004) ArticleTitleDefining palliative surgery in patients receiving noncurative resections for gastric cancer J Am Coll Surg 198 1013–21 Occurrence Handle15194084 Occurrence Handle10.1016/j.jamcollsurg.2004.02.007
LE McCahill DD Smith T Borneman G Juarez C Cullinane DZJ Chu et al. (2003) ArticleTitleA prospective evaluation of palliative outcomes for surgery of advanced malignancies Ann Surg Oncol 10 654–63 Occurrence Handle12839850 Occurrence Handle10.1245/ASO.2003.06.011
H Medina-Franco A Contreras-Saldivar A Ramos de la Medina P Palacios-Sánchez R Cortés-González JA Ugarte (2004) ArticleTitleSurgery for stage IV gastric cancer Am J Surg 187 543–6 Occurrence Handle15041508 Occurrence Handle10.1016/j.amjsurg.2003.12.045
SS Wohrer M Raderer M Hejna (2004) ArticleTitlePalliative chemotherapy for advanced gastric cancer Ann Oncol 15 1585–95 Occurrence Handle15520058 Occurrence Handle10.1093/annonc/mdh422 Occurrence Handle1:STN:280:DC%2BD2crkslSltg%3D%3D
FL Greene DL Page ID Fleming InstitutionalAuthorNameAmerican Joint Committee on Cancer (2002) AJCC Cancer staging manual EditionNumbersixth edition Springer-Verlag New York Berlin Heidelberg Tokyo
LF Oñate-Ocaña SA Cortés-Cárdenas V Aiello-Crocifoglio R Mondragón-Sánchez JM Ruiz-Molina (2000) ArticleTitlePreoperative multivariate prediction of morbidity after gastrectomy for adenocarcinoma Ann Surg Oncol 7 281–8 Occurrence Handle10819368 Occurrence Handle10.1007/s10434-000-0281-9
EL Kaplan PM Meier (1958) ArticleTitleNonparametric estimation from incomplete observations J Am Stat Soc 53 457–81
JM Bland DG Altman (2004) ArticleTitleThe logrank test BMJ 328 1073 Occurrence Handle15117797 Occurrence Handle10.1136/bmj.328.7447.1073
World Health Organization. Cancer pain relief and palliative care: report of a WHO Expert Committee. Geneva: World Health Organization;1990; 11: Technical report series no. 804
AW Boodie MJ McMurtrey GG Giacco CM McBride (1983) ArticleTitlePalliative total gastrectomy and esophagogastrectomy. A reevaluation Cancer 51 1195–200 Occurrence Handle10.1002/1097-0142(19830401)51:7<1195::AID-CNCR2820510705>3.0.CO;2-V
W Lawrence SuffixJr G McNeer (1958) ArticleTitleThe effectiveness of surgery of palliation of incurable gastric cancer Cancer 11 28–32 Occurrence Handle13500292 Occurrence Handle10.1002/1097-0142(195801/02)11:1<28::AID-CNCR2820110108>3.0.CO;2-7
RF Saidi SG ReMine PS Dudrick NN Hanna (2006) ArticleTitleIs there a role for palliative gastrectomy in patients with stage IV gastric cancer? World J Surg 30 21–7 Occurrence Handle16369718 Occurrence Handle10.1007/s00268-005-0129-3
Goel A, Khandelwal C. Role of palliative gastrectomy in locally advanced gastric cancer: experience of 313 cases. American Society of Clinical Oncology, American Society for Therapeutic Radiology and Oncology, American Gastroenterological Association and Society of Surgical Oncology: 2006 Gastrointestinal Cancers Symposium. www.asco.org (accessed December 6, 2006)
HH Hartgrink H Putter E Klein Kranenbarg JJ Bonenkamp CJ van de Velde InstitutionalAuthorNameDutch Gastric Cancer Group (2002) ArticleTitleValue of palliative resection in gastric cancer Br J Surg 89 1438–43 Occurrence Handle12390389 Occurrence Handle10.1046/j.1365-2168.2002.02220.x Occurrence Handle1:STN:280:DC%2BD38njt1anug%3D%3D
A Mittal J Windsor J Woodfield P Casey M Lane (2004) ArticleTitleMatched study of three methods for palliation of malignant pyloroduodenal obstruction Br J Surg 91 205–9 Occurrence Handle14760669 Occurrence Handle10.1002/bjs.4396 Occurrence Handle1:STN:280:DC%2BD2c%2FlvVCksA%3D%3D
JM Blazeby K Avery M Sprangers H Pikhart P Fayers J Donovan (2006) ArticleTitleHealth-related quality of life measurement in randomized clinical trials in surgical oncology J Clin Oncol 24 3178–86 Occurrence Handle16809741 Occurrence Handle10.1200/JCO.2005.05.2951
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Oñate-Ocaña, L., Méndez-Cruz, G., Hernández-Ramos, R. et al. Experience of surgical morbidity after palliative surgery in patients with gastric carcinoma. Gastric Cancer 10, 215–220 (2007). https://doi.org/10.1007/s10120-007-0437-4
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DOI: https://doi.org/10.1007/s10120-007-0437-4