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The evaluation of surgical treatment for gastric cancer patients with noncurative resection

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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.

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Abbreviations

TG:

Total gastrectomy

DG:

Distal gastrectomy

OS:

Overall survival

MST:

Median survival time

HR:

Hazard ratio

CI:

Confidence interval

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Teiji Naka, Makoto Iwahashi, Mikihito Nakamori, Masaki Nakamura, Toshiyasu Ojima, Takeshi Iida, Masahiro Katsuda, Tsuji Toshiaki, Hayata Keiji & Hiroki Yamaue

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  1. Teiji Naka
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  2. Makoto Iwahashi
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  3. Mikihito Nakamori
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  4. Masaki Nakamura
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  5. Toshiyasu Ojima
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  6. Takeshi Iida
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  7. Masahiro Katsuda
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Correspondence to Hiroki Yamaue.

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Naka, T., Iwahashi, M., Nakamori, M. et al. The evaluation of surgical treatment for gastric cancer patients with noncurative resection. Langenbecks Arch Surg 397, 959–966 (2012). https://doi.org/10.1007/s00423-012-0906-z

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  • DOI: https://doi.org/10.1007/s00423-012-0906-z

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