Outcome of palliative total gastrectomy for stage IV proximal gastric cancer

Zhang, Jianzhong; Lu, Huishan; Huang, Chang‐Ming; Wu, Xing-Yuan; Wang, Chuang; Guan, Guoxian; Zhen, Jian-Wei; Huang, Heguang; Zhang, Xianfu

doi:10.1016/j.amjsurg.2010.05.014

Cited by 35 publications

(21 citation statements)

References 19 publications

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“…As indicated in the previous reports, some investigators assure as if palliative gastrectomy induces survival gain in initially metastatic gastric cancer [13141516]. However, as shown in our results, the benefit of noncurative surgery could not outweigh the prognostic effect of disease-burden.…”

Section: Discussionsupporting

confidence: 53%

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Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?

et al. 2017

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PurposeThe purpose of this study is to suggest a treatment strategy for stage IV gastric cancer by investigating the behavioral difference between initially and recurrent metastatic disease.MethodsWe reviewed the medical records of the patients who underwent chemotherapy alone for metastatic gastric cancer between January 2006 and September 2013. Patients were divided into those who underwent chemotherapy for metastatic disease since initial diagnosis (IM group) and for metastatic recurrence after curative surgery (RM group). Survival and causes of death were compared between the 2 groups, and significant prognostic factors were also investigated.ResultsA total of 170 patients were enrolled in this study. Of these patients, 104 were included in the IM group and 66 in the RM group. Overall survival of the IM group did not differ from that of RM (P = 0.569). In the comparison of the causes of death, the IM group had a greater tendency to die from bleeding (P = 0.054) and pneumonia (P = 0.055). In multivariate analysis, bone metastasis (P < 0.001; HR = 2.847), carcinoma peritonei (P = 0.047; HR = 1.766), and the frequency of chemotherapy (P < 0.001; HR = 0.777) were significantly associated with overall survival of IM group.ConclusionDisease-burden mainly contributes to the prognosis of metastatic gastric cancer, although noncurative gastrectomy may be helpful in reducing the mortality of initially metastatic disease. Therefore, disease-burden should be also prioritized in determining the treatment strategies for stage IV gastric cancer.

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Section: Discussionsupporting

confidence: 53%

“…Some investigators described that surgical resection might cause a favorable prognosis through reduction of tumor-burden [13141516]. Considering these reports, recurrent metastatic gastric cancer is expected to have a smaller disease-burden than initially metastatic disease, because curative gastrectomy was performed before.…”

Section: Introductionmentioning

confidence: 99%

Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?

et al. 2017

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“…The decision to manage patients palliatively should not limit the extent of surgery; a large retrospective study has shown that more radical procedures may improve survival and quality of life in eligible patients. 55 A gastrojejunostomy, which can often be performed laparoscopically, and endoscopic stenting can be performed in those who are not eligible for first line surgical procedures.…”

Section: Palliative Surgerymentioning

confidence: 99%

The diagnosis and management of gastric cancer

Thrumurthy

Chaudry

Hochhauser

et al. 2013

BMJ

138

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“…Different treatments have been employed to treat symptoms from local tumor extension. These include argon plasma laser coagulation, palliative gastrectomy, gastric bypass, stenting, palliative chemotherapy and palliative radiotherapy (RT) . Palliative RT is attractive as it is non‐invasive and has been shown to be effective in randomized trials in palliating bleeding and obstructive symptoms in patients with advanced lung and bladder cancers …”

Section: Introductionmentioning

confidence: 99%

Palliative radiotherapy in symptomatic locally advanced gastric cancer: A phase II trial

Tey

Zheng²,

Soon

et al. 2019

Cancer Medicine

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To evaluate the response and quality of life of palliative gastric radiotherapy in patients with symptomatic locally advanced gastric cancer. Patients with bleeding, pain or obstruction and were treated with palliative gastric radiotherapy to a dose of 36 Gy in 12 daily fractions. The primary outcomes were symptom response rates. Secondary outcomes included overall survival, adverse events and proportion of patients with ≥10‐point absolute improvement in the fatigue, nausea/vomiting and pain subscales in the EORTC Qualify of Life Questionnaire C30 (EORTC QLQ‐C30) and dysphagia/pain subscales in the gastric specific module (STO22) at the end of RT and 1 month after the completion of radiotherapy. Fifty patients were accrued. Median survival duration was 85 days. 40/50 patients (80%) with bleeding, 2/2 (100%) patients with obstruction and 1/1 (100%) patient with pain responded to radiotherapy. Improvements fatigue, nausea/vomiting and pain subscales of the EORTC QLQ‐C30 was seen in 50%, 28% and 44% of patients at the end of RT and in 63%, 31% and 50% of patients 1 month after RT. Improvements in dysphagia/pain subscales of the STO22 was seen in 42% and 28% of patients at then end of RT and 44% and 19% of patients 1 month after RT. Two patients (5%) had grade 3 anorexia and gastritis. Palliative gastric radiotherapy was effective, well tolerated and resulted in improvement in fatigue, dysphagia and pain at the end of radiotherapy and 1 month after the completion of radiotherapy in a significant proportion of patients.

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Outcome of palliative total gastrectomy for stage IV proximal gastric cancer

Cited by 35 publications

References 19 publications

Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?

Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?

The diagnosis and management of gastric cancer

Palliative radiotherapy in symptomatic locally advanced gastric cancer: A phase II trial

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