Wednesday, 25 June 2008

Impact of palliative gastrectomy in patients with incurable advanced gastric cancer

Impact of palliative gastrectomy in patients with incurable advanced gastric cancer.
Anticancer research, Mar-Apr 2008, vol. 28, no. 2B, p. 1309-15
Kunisaki-Chikara, Makino-Hirochika, Takagawa-Ryo et al
Abstract
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.

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