BACKGROUND: The survival benefit of palliative gastrectomy in patients with peritoneal metastasis as a single incurable factor remains unclear. METHODS: A total of 148 gastric cancer patients with peritoneal metastasis underwent gastrectomy or chemotherapy at the Shizuoka Cancer Center between September 2002 and December 2008 and were included in this study. The effects of gastrectomy and chemotherapy on their long-term outcome were investigated. Multivariate analysis was also performed to identify independent prognostic factors. RESULTS: Gastrectomy was performed in 82 patients and subsequent chemotherapy was administered to 55. Chemotherapy was selected as an initial treatment for 66 patients. Median survival time (MST) was identical between patients with and without gastrectomy (13.1 vs. 12.0 months; P = 0.410). Conversely, MST was significantly longer in patients who received chemotherapy (13.7 months) than those who did not (7.1 months; P = 0.048). According to the results of multivariate analysis, chemotherapy (hazards ratio [HR] = 0.476; 95 % CI = 0.288-0.787) was selected as an independent prognostic factor, while gastrectomy was not. CONCLUSIONS: The results of the present study did not show a survival benefit of palliative gastrectomy in selected patients with peritoneal metastasis. Instead, chemotherapy has to be considered as an initial treatment for these patients.
BACKGROUND: The survival benefit of palliative gastrectomy in patients with peritoneal metastasis as a single incurable factor remains unclear. METHODS: A total of 148 gastric cancerpatients with peritoneal metastasis underwent gastrectomy or chemotherapy at the Shizuoka Cancer Center between September 2002 and December 2008 and were included in this study. The effects of gastrectomy and chemotherapy on their long-term outcome were investigated. Multivariate analysis was also performed to identify independent prognostic factors. RESULTS: Gastrectomy was performed in 82 patients and subsequent chemotherapy was administered to 55. Chemotherapy was selected as an initial treatment for 66 patients. Median survival time (MST) was identical between patients with and without gastrectomy (13.1 vs. 12.0 months; P = 0.410). Conversely, MST was significantly longer in patients who received chemotherapy (13.7 months) than those who did not (7.1 months; P = 0.048). According to the results of multivariate analysis, chemotherapy (hazards ratio [HR] = 0.476; 95 % CI = 0.288-0.787) was selected as an independent prognostic factor, while gastrectomy was not. CONCLUSIONS: The results of the present study did not show a survival benefit of palliative gastrectomy in selected patients with peritoneal metastasis. Instead, chemotherapy has to be considered as an initial treatment for these patients.
Authors: Abeezar I Sarela; Thomas J Miner; Martin S Karpeh; Daniel G Coit; David P Jaques; Murray F Brennan Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
Authors: Jung Ho Shim; Han Mo Yoo; Han Hong Lee; Jun Gi Kim; Hae Myung Jeon; Kyo Young Song; Cho Hyun Park Journal: Surg Endosc Date: 2011-05-02 Impact factor: 4.584
Authors: Su Jin Kim; Hyung-Ho Kim; Young Hoon Kim; Sun Hwi Hwang; Hye Seung Lee; Do Joong Park; So Yeon Kim; Kyoung Ho Lee Journal: Radiology Date: 2009-09-29 Impact factor: 11.105
Authors: Beate Rau; Andreas Brandl; Pompiliu Piso; Jörg Pelz; Peter Busch; Cedric Demtröder; Silke Schüle; Hans-Jürgen Schlitt; Marc Roitman; Jürgen Tepel; Udo Sulkowski; Faik Uzunoglu; Michael Hünerbein; Rüdiger Hörbelt; Michael Ströhlein; Stefan Beckert; Ingmar Königsrainer; Alfred Königsrainer Journal: Gastric Cancer Date: 2019-06-21 Impact factor: 7.370