Erschienen in:
01.08.2012 | Original Article
The evaluation of surgical treatment for gastric cancer patients with noncurative resection
verfasst von:
Teiji Naka, Makoto Iwahashi, Mikihito Nakamori, Masaki Nakamura, Toshiyasu Ojima, Takeshi Iida, Masahiro Katsuda, Tsuji Toshiaki, Hayata Keiji, Hiroki Yamaue
Erschienen in:
Langenbeck's Archives of Surgery
|
Ausgabe 6/2012
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Abstract
Purpose
This study aims to analyze the results of treatment in a series of 233 gastric cancer patients who underwent a noncurative resection.
Methods
We performed a retrospective study of patients with noncurative treatment for advanced gastric cancer who were divided into three treatment groups: total gastrectomy (TG, n = 150), distal gastrectomy (DG, n = 44), and nonresection (NR, bypass procedure or chemotherapy only, n = 39).
Results
In multivariate analysis, surgical treatment (TG) and an absence of chemotherapy were significant independent prognostic factors for a poor survival. In the late period, the overall survival rate was significantly lower in the TG group than in the DG group (p = 0.005) and was marginally lower than in the NR group (p = 0.054). The resection group had a poorer compliance for chemotherapy than the NR group, and the TG group had a poorer compliance than the DG group (p < 0.01). The morbidity rate was higher in the TG group than in the DG group (p < 0.05).
Conclusions
TG is considered to be inappropriate for the treatment of noncurative gastric cancer because of the poor prognosis, high morbidity rates, and poor compliance for chemotherapy associated with the procedure. However, noncurative DG was acceptable and postoperative chemotherapy should be used in selected patients.