Cargando…
Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer
Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996496/ https://www.ncbi.nlm.nih.gov/pubmed/33652574 http://dx.doi.org/10.3390/medicina57030198 |
_version_ | 1783670115552722944 |
---|---|
author | Park, Ji Yeon Yu, Byunghyuk Park, Ki Bum Kwon, Oh Kyoung Lee, Seung Soo Chung, Ho Young |
author_facet | Park, Ji Yeon Yu, Byunghyuk Park, Ki Bum Kwon, Oh Kyoung Lee, Seung Soo Chung, Ho Young |
author_sort | Park, Ji Yeon |
collection | PubMed |
description | Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis. |
format | Online Article Text |
id | pubmed-7996496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79964962021-03-27 Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer Park, Ji Yeon Yu, Byunghyuk Park, Ki Bum Kwon, Oh Kyoung Lee, Seung Soo Chung, Ho Young Medicina (Kaunas) Article Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis. MDPI 2021-02-26 /pmc/articles/PMC7996496/ /pubmed/33652574 http://dx.doi.org/10.3390/medicina57030198 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ). |
spellingShingle | Article Park, Ji Yeon Yu, Byunghyuk Park, Ki Bum Kwon, Oh Kyoung Lee, Seung Soo Chung, Ho Young Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title | Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title_full | Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title_fullStr | Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title_full_unstemmed | Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title_short | Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer |
title_sort | impact of palliative gastrectomy in patients with incurable gastric cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996496/ https://www.ncbi.nlm.nih.gov/pubmed/33652574 http://dx.doi.org/10.3390/medicina57030198 |
work_keys_str_mv | AT parkjiyeon impactofpalliativegastrectomyinpatientswithincurablegastriccancer AT yubyunghyuk impactofpalliativegastrectomyinpatientswithincurablegastriccancer AT parkkibum impactofpalliativegastrectomyinpatientswithincurablegastriccancer AT kwonohkyoung impactofpalliativegastrectomyinpatientswithincurablegastriccancer AT leeseungsoo impactofpalliativegastrectomyinpatientswithincurablegastriccancer AT chunghoyoung impactofpalliativegastrectomyinpatientswithincurablegastriccancer |