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Survival Benefit of Palliative Gastrectomy in Gastric Cancer Patients with Peritoneal Metastasis

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Abstract

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.

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Authors and Affiliations

  1. Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Masanori Tokunaga, Masanori Terashima, Yutaka Tanizawa, Etsuro Bando & Taiichi Kawamura

  2. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan

    Hirofumi Yasui & Narikazu Boku

Authors
  1. Masanori Tokunaga
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  2. Masanori Terashima
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  3. Yutaka Tanizawa
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  4. Etsuro Bando
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  5. Taiichi Kawamura
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  6. Hirofumi Yasui
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  7. Narikazu Boku
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Correspondence to Masanori Tokunaga.

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Tokunaga, M., Terashima, M., Tanizawa, Y. et al. Survival Benefit of Palliative Gastrectomy in Gastric Cancer Patients with Peritoneal Metastasis. World J Surg 36, 2637–2643 (2012). https://doi.org/10.1007/s00268-012-1721-y

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  • DOI: https://doi.org/10.1007/s00268-012-1721-y

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