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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...

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Autores principales: Park, Ji Yeon, Yu, Byunghyuk, Park, Ki Bum, Kwon, Oh Kyoung, Lee, Seung Soo, Chung, Ho Young
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
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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.
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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
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