Value of nonpalliative resection as a therapeutic and pre-emptive operation for metastatic gastric cancer

Seong-Heum Park, Jong Han Kim, Joong Min Park, Sungsoo Park, Seung Joo Kim, Chong Suk Kim, Young Jae Mok

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Abstract

Introduction: The value of nonpalliative resection in metastatic gastric cancer has not been clearly defined. Methods: The survival and incidence of subsequent palliative interventions in 72 patients with metastatic gastric cancer who underwent nonpalliative resection were retrospectively compared with those of 56 patients that did not undergo resection. Results: The median survival of patients who underwent resection was greater than that of patients who did not (12.0 months versus 4.8 months; p = 0.000). However, more patients in the resection group had a good performance status, no neighboring organ invasion, and only one metastatic site, and this might have caused the survival difference. Adjuvant chemotherapy was the only independent predictor of survival after resection. Incidences of subsequent palliative procedures were not significantly different in the two study groups (43.1% in resection group versus 39.3% in the nonresection group; p = 0.668). However, the mean interval between operation and the first procedure was significantly different in the two groups (287.3 days in the resection group versus 164.1 days in the nonresection group; p = 0.032). Conclusions: The survival of the patients that underwent nonpalliative resection was poor, and nonpalliative gastrectomy did not decrease requirements for subsequent palliative procedures. Only a few patients with a favorable response to adjuvant chemotherapy survived longer after resection and benefited from a longer symptom-free period until the subsequent palliative procedures were required. Nonpalliative resection should be reserved for selected patients based on performance status, resection feasibilities and metastatic tumor loads, and adjuvant chemotherapy should be combined as part of multimodality therapy.

Original languageEnglish
Pages (from-to)303-311
Number of pages9
JournalWorld Journal of Surgery
Volume33
Issue number2
DOIs
Publication statusPublished - 2009 Feb 1

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Stomach Neoplasms
Adjuvant Chemotherapy
Survival
Therapeutics
Incidence
Gastrectomy
Tumor Burden

ASJC Scopus subject areas

  • Surgery

Cite this

Value of nonpalliative resection as a therapeutic and pre-emptive operation for metastatic gastric cancer. / Park, Seong-Heum; Kim, Jong Han; Park, Joong Min; Park, Sungsoo; Kim, Seung Joo; Kim, Chong Suk; Mok, Young Jae.

In: World Journal of Surgery, Vol. 33, No. 2, 01.02.2009, p. 303-311.

Research output: Contribution to journalArticle

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N2 - Introduction: The value of nonpalliative resection in metastatic gastric cancer has not been clearly defined. Methods: The survival and incidence of subsequent palliative interventions in 72 patients with metastatic gastric cancer who underwent nonpalliative resection were retrospectively compared with those of 56 patients that did not undergo resection. Results: The median survival of patients who underwent resection was greater than that of patients who did not (12.0 months versus 4.8 months; p = 0.000). However, more patients in the resection group had a good performance status, no neighboring organ invasion, and only one metastatic site, and this might have caused the survival difference. Adjuvant chemotherapy was the only independent predictor of survival after resection. Incidences of subsequent palliative procedures were not significantly different in the two study groups (43.1% in resection group versus 39.3% in the nonresection group; p = 0.668). However, the mean interval between operation and the first procedure was significantly different in the two groups (287.3 days in the resection group versus 164.1 days in the nonresection group; p = 0.032). Conclusions: The survival of the patients that underwent nonpalliative resection was poor, and nonpalliative gastrectomy did not decrease requirements for subsequent palliative procedures. Only a few patients with a favorable response to adjuvant chemotherapy survived longer after resection and benefited from a longer symptom-free period until the subsequent palliative procedures were required. Nonpalliative resection should be reserved for selected patients based on performance status, resection feasibilities and metastatic tumor loads, and adjuvant chemotherapy should be combined as part of multimodality therapy.

AB - Introduction: The value of nonpalliative resection in metastatic gastric cancer has not been clearly defined. Methods: The survival and incidence of subsequent palliative interventions in 72 patients with metastatic gastric cancer who underwent nonpalliative resection were retrospectively compared with those of 56 patients that did not undergo resection. Results: The median survival of patients who underwent resection was greater than that of patients who did not (12.0 months versus 4.8 months; p = 0.000). However, more patients in the resection group had a good performance status, no neighboring organ invasion, and only one metastatic site, and this might have caused the survival difference. Adjuvant chemotherapy was the only independent predictor of survival after resection. Incidences of subsequent palliative procedures were not significantly different in the two study groups (43.1% in resection group versus 39.3% in the nonresection group; p = 0.668). However, the mean interval between operation and the first procedure was significantly different in the two groups (287.3 days in the resection group versus 164.1 days in the nonresection group; p = 0.032). Conclusions: The survival of the patients that underwent nonpalliative resection was poor, and nonpalliative gastrectomy did not decrease requirements for subsequent palliative procedures. Only a few patients with a favorable response to adjuvant chemotherapy survived longer after resection and benefited from a longer symptom-free period until the subsequent palliative procedures were required. Nonpalliative resection should be reserved for selected patients based on performance status, resection feasibilities and metastatic tumor loads, and adjuvant chemotherapy should be combined as part of multimodality therapy.

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