Non-curative gastrectomy for metastatic gastric cancer: Rationale and long-term outcome in multicenter settings

Kulig, Piotr; Sierżęga, Marek; Kowalczyk, Tomasz; Kołodziejczyk, Piotr; Kulig, Jan

doi:10.1016/j.ejso.2012.01.013

Cited by 39 publications

(41 citation statements)

References 20 publications

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“…The mortality rate for gastrectomy performed for any intent was 0% -21%; the mortality rate for non-resection surgeries was 0%-39% 43 . In the literature update, which included all moderate-quality studies, procedure-related mortality for gastrectomy performed in noncurative studies was 1.1% -9.1% 44,48 ; the mortality rate for non-resection surgeries in noncurative studies was 4.8%-10% 21,47 .…”

Section: Key Evidence For Recommendationmentioning

confidence: 99%

Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

et al. 2017

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Section: Key Evidence For Recommendationmentioning

confidence: 99%

Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

et al. 2017

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“…Comparando la sobrevida de los 4 grupos de pacientes llama la atención que: a) se aprecia mayor pero no significativa sobrevida en pacientes con metástasis hepáticas solamente, comparados con los otros grupos y b) una mejor sobrevida en pacientes sometidos a gastrectomía total o subtotal que fue significativa. Este hecho ha sido publicado por varios autores extranjeros [14][15][16][17][18][19][20][21][22][23][24][25][26] . Se ha sugerido que el agregado de quimioterapia postoperatoria en pacientes con resección paliativa parece estar asociada a una mayor sobrevida que con la cirugía sola 19,22,23 .…”

Section: Discussionunclassified

Sobrevida De Pacientes Con Cáncer Gástrico Etapas Iiic Y Iv Sometidos a Cirugía: Parte Ii De Estudio Prospectivo 2004-2012

et al. 2014

Rev Chil Cir

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Survival of patients with advanced gastric cancer subjected to palliative surgery Background: Most patients with gastric cancer consult when the tumor is an advanced stage. Aim: To assess the survival of patients with gastric cancer in stage IIIc or IV subjected to surgery. Patients and Methods: Prospective study of patients with gastric cancer in stages IIIc (spreading to nearby organs or serosa) or IV (spreading to distant organs), who consulted between 2004 and 2012. A surgical exploration was carried out in all patients performing a palliative total or subtotal gastrectomy, a gastrojejunal anastomosis or only an exploration. Twenty five patients received adjuvant chemotherapy. All were followed until their death. Results: A surgical resection was performed in 61 patients (64%) with an operative mortality of 5 and 0% for total and subtotal gastrectomy, respectively. The mortality of non-resected patients was 6.4% with a maximal survival of 15 months after surgery. No significant differences in survival were observed between patients with hepatic or peritoneal metastases. Adjuvant chemotherapy significantly improved survival among patients subjected to gastric resection. Conclusions: Among patients with gastric cancer, palliative gastrectomy may improve quality of life and adjuvant chemotherapy apparently improves survival.

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“…24 However, studies published after the mid-1990s consistently reported surgical mortality rates for noncurative gastrectomy of less than 7%, and such outcomes are continuously improving owing to advancements in patient selection, anaesthetic techniques, perioperative nutritional support, management of postoperative complications, and enhanced recovery programmes. 25 Large cohort studies from high-volume tertiary centres have suggested that approximately 20% of patients with stage IV gastric cancer undergo palliative gastric resection (for example, partial or total gastrectomy) to relieve tumour-related symptoms, avoid tumour-related complications, and improve QoL. 25 Over half of patients with stage IV gastric cancer who receive surgical intervention undergo nonresectional procedures (including gastric bypass procedures, g astrostomy, and jejunostomy).…”

Section: Surgery For Incurable Gastric Cancermentioning

confidence: 99%

“…25 Large cohort studies from high-volume tertiary centres have suggested that approximately 20% of patients with stage IV gastric cancer undergo palliative gastric resection (for example, partial or total gastrectomy) to relieve tumour-related symptoms, avoid tumour-related complications, and improve QoL. 25 Over half of patients with stage IV gastric cancer who receive surgical intervention undergo nonresectional procedures (including gastric bypass procedures, g astrostomy, and jejunostomy). 25 Despite the general consensus that surgery is indicated to palliate severe gastrointestinal symptoms, such as refractory haemorrhage or obstructions, in patients with stage IV disease, 26 the utility of noncurative surgery in patients with minimal symptoms and incurable disease remains the subject of intense debate.…”

Section: Surgery For Incurable Gastric Cancermentioning

confidence: 99%

Does surgery have a role in managing incurable gastric cancer?

et al. 2015

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Although the incidence of gastric cancer is decreasing, the outcomes of this disease are among the poorest of all solid-organ tumours, predominantly due to the frequent presence of stage IV metastatic disease at primary presentation. Stage IV gastric cancer is incurable and carries a very poor prognosis (5-year survival rate of ∼4%); palliative chemotherapy remains the standard of care, but increasing evidence indicates that palliative surgery can provide a prognostic and symptomatic benefit, particularly in combination with chemotherapy and/or radiotherapy. Ongoing prospective trials should further clarify the efficacy of palliative surgery in comparison with other treatment modalities. Until such data are available, surgery should not be offered as a standard first-line treatment, but can be considered in selected cases after thorough multidisciplinary discussions involving the patient. Patient selection for both gastrectomy and nonresectional surgery must include consideration of various factors that predict quality of life after surgery. This Perspectives summarizes the available evidence and discusses the utility of palliative surgery in relation to other therapeutic modalities in the management of incurable gastric cancer.

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Non-curative gastrectomy for metastatic gastric cancer: Rationale and long-term outcome in multicenter settings

Cited by 39 publications

References 20 publications

Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

Sobrevida De Pacientes Con Cáncer Gástrico Etapas Iiic Y Iv Sometidos a Cirugía: Parte Ii De Estudio Prospectivo 2004-2012

Does surgery have a role in managing incurable gastric cancer?

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