Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 2/2008

01-02-2008 | Original Paper

Palliative gastrectomy and chemotherapy for stage IV gastric cancer

Authors: Sheng-Zhang Lin, Hong-Fei Tong, Tao You, Yao-Jun Yu, Wei-Jun Wu, Cong Chen, Wei Zhang, Bing Ye, Chun-Ming Li, Zhi-Qiang Zhen, Jia-Rong Xu, Jun-Liang Zhou

Published in: Journal of Cancer Research and Clinical Oncology | Issue 2/2008

Login to get access

Abstract

Purpose

To investigate the value of palliative gastrectomy and chemotherapy in a large series of patients with stage IV gastric cancer.

Methods

A total of 389 patients were identified in survival analysis. Among which, 183 cases received palliative gastrectomy (PG) and 206 cases received unresectable operation, 184 cases received palliative chemotherapy (PC) and 205 cases did not receive chemotherapy. The survival advantages of patients, based on treatments modality, were also analyzed in patients with liver metastasis, peritoneal dissemination and lymph node metastasis.

Results

The 1-year, 3-year, 5-year survival rate of those patients who were treated with PG + PC were 85.7% (96/112), 32.1% (36/112), and 8.9% (10/112), which were far better than those who were not. For those patients with liver metastasis, peritoneal dissemination, and/or N3 lymph node metastasis, survival advantages were also present if treated with this multimodality approach.

Conclusion

The survival time and palliative duration were significantly longer in patients after PG than after non-resection operations. Postoperative chemotherapy prolonged the survival time of patients after palliative surgery. PG combined with adjuvant chemotherapy may improve survival in patients with stage IV gastric cancer, even with liver metastasis, peritoneal dissemination, and lymph node metastasis.
Literature
go back to reference AJCC (2003) Cancer staging manual, 6th edn, Springer, New York AJCC (2003) Cancer staging manual, 6th edn, Springer, New York
go back to reference Doglietto GB, Pacelli F, Caprino P, Alfieri S, Carriero C, Malerba M, Crucitti (1999) Palliative surgery for far-advanced gastric cancer: a retrospective study on 305 consecutive patients. Am Surg 65:352–355PubMed Doglietto GB, Pacelli F, Caprino P, Alfieri S, Carriero C, Malerba M, Crucitti (1999) Palliative surgery for far-advanced gastric cancer: a retrospective study on 305 consecutive patients. Am Surg 65:352–355PubMed
go back to reference Kakeji Y, Maehara Y, Tomoda M, Kabashima A, Ohmori M, Oda S, Ohno S, Sugimachi K (1998) Long-term survival of patients with stage IV gastric carcinoma. Cancer 82:2307–2311PubMedCrossRef Kakeji Y, Maehara Y, Tomoda M, Kabashima A, Ohmori M, Oda S, Ohno S, Sugimachi K (1998) Long-term survival of patients with stage IV gastric carcinoma. Cancer 82:2307–2311PubMedCrossRef
go back to reference Kodera Y, Yamamura Y, Shimizu Y, Torii A, Hirai T, Yasui K, Morimoto T, Kato T, Kito T (1997) Metastatic gastric lymph node rate is a significant prognostic factor for resectable stage IV stomach cancer. J Am Coll Surg 185:65–69PubMed Kodera Y, Yamamura Y, Shimizu Y, Torii A, Hirai T, Yasui K, Morimoto T, Kato T, Kito T (1997) Metastatic gastric lymph node rate is a significant prognostic factor for resectable stage IV stomach cancer. J Am Coll Surg 185:65–69PubMed
go back to reference Lawrence W Jr, McNeer G (1958) The effectiveness of surgery for palliation of incurable gastric cancer. Cancer 11:28–32PubMedCrossRef Lawrence W Jr, McNeer G (1958) The effectiveness of surgery for palliation of incurable gastric cancer. Cancer 11:28–32PubMedCrossRef
go back to reference Maehara Y, Moririguchi S, Kakeji S, Kohnoue S, Korenaga D, Haraguchi M, Sugimachi K (1991) Pertinent risk factors and gastric carcinoma with synchronous peritoneal dissemination or liver metastasis. Surgery 110:820–823PubMed Maehara Y, Moririguchi S, Kakeji S, Kohnoue S, Korenaga D, Haraguchi M, Sugimachi K (1991) Pertinent risk factors and gastric carcinoma with synchronous peritoneal dissemination or liver metastasis. Surgery 110:820–823PubMed
go back to reference Medina-Franco H, Contreras-Saldivar A, Ramos-De La Medina A, Palacios-Sanchez P, Cortes-Gonzalez R, Ugarte JA (2004) Surgery for stage IV gastric cancer. Am J Surg 187:543–546PubMedCrossRef Medina-Franco H, Contreras-Saldivar A, Ramos-De La Medina A, Palacios-Sanchez P, Cortes-Gonzalez R, Ugarte JA (2004) Surgery for stage IV gastric cancer. Am J Surg 187:543–546PubMedCrossRef
go back to reference Miner TJ, Karpeh MS (2004) Gastrectomy for gastric cancer: defining critical elements of patient selection and outcome assessment. Surg Oncol Clin N Am 13:455–466PubMedCrossRef Miner TJ, Karpeh MS (2004) Gastrectomy for gastric cancer: defining critical elements of patient selection and outcome assessment. Surg Oncol Clin N Am 13:455–466PubMedCrossRef
go back to reference Miyazaki M, Itoh H, Nakagawa K, Ambiru S, Shimizu H, Togawa A, Shiobara M, Ohtuska M, Sasada K, Shimizu Y, Yoshioka S, Nakajima N, Suwa T, Kimura F (1997) Hepatic resection of liver metastases from gastric cancer. Am J Gastroenterol 62:490–493 Miyazaki M, Itoh H, Nakagawa K, Ambiru S, Shimizu H, Togawa A, Shiobara M, Ohtuska M, Sasada K, Shimizu Y, Yoshioka S, Nakajima N, Suwa T, Kimura F (1997) Hepatic resection of liver metastases from gastric cancer. Am J Gastroenterol 62:490–493
go back to reference Monson JR, Donohue JH, McIlrath DC, Farnell MB, Ilstrup DM (1991) Total gastrectomy for advanced cancer. A worthwhile palliative procedure. Cancer 68:1863–1868PubMedCrossRef Monson JR, Donohue JH, McIlrath DC, Farnell MB, Ilstrup DM (1991) Total gastrectomy for advanced cancer. A worthwhile palliative procedure. Cancer 68:1863–1868PubMedCrossRef
go back to reference Ohno S, Maeta M, Oka A, Hirooka Y, Baba H, Furusawa M (1994) Peritoneal dissemination after a curative gastrectomy in patients with undifferentiated adenocarcinoma of the stomach. Semin Surg Oncol 10:117–120PubMedCrossRef Ohno S, Maeta M, Oka A, Hirooka Y, Baba H, Furusawa M (1994) Peritoneal dissemination after a curative gastrectomy in patients with undifferentiated adenocarcinoma of the stomach. Semin Surg Oncol 10:117–120PubMedCrossRef
go back to reference Otani S, Maeta M, Oka A, Hirooka Y, Tsujitani S, Ikeguchi M, Harnazoe R, Kaibara N (1995) Long-term survival of 5 years following initial surgery for gastric cancer and simultaneous disseminated peritoneal metastasis: report of a case. Surg Today 25:959–961PubMedCrossRef Otani S, Maeta M, Oka A, Hirooka Y, Tsujitani S, Ikeguchi M, Harnazoe R, Kaibara N (1995) Long-term survival of 5 years following initial surgery for gastric cancer and simultaneous disseminated peritoneal metastasis: report of a case. Surg Today 25:959–961PubMedCrossRef
go back to reference Ouchi K, Sugawara T, Ono H, Fujiya T, Kamiyama Y, Kakugawa Y, Mikuni J, Yamanami H (1998) Therapeutic significance of palliative operations for gastric cancer for survival and quality of life. J Surg Oncol 69:41–44PubMedCrossRef Ouchi K, Sugawara T, Ono H, Fujiya T, Kamiyama Y, Kakugawa Y, Mikuni J, Yamanami H (1998) Therapeutic significance of palliative operations for gastric cancer for survival and quality of life. J Surg Oncol 69:41–44PubMedCrossRef
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMedCrossRef Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMedCrossRef
go back to reference Sarela AI, Miner TJ, Jaques DP, Karpeh MS, Brennan MF (2004) Outcomes for patients with laparoscopically staged M1 gastric adenocarcinoma. Br J Surg 91:514–520CrossRef Sarela AI, Miner TJ, Jaques DP, Karpeh MS, Brennan MF (2004) Outcomes for patients with laparoscopically staged M1 gastric adenocarcinoma. Br J Surg 91:514–520CrossRef
go back to reference Sastre J, Garcia-Saenz JA, Diaz-Rubio E (2006) Chemotherapy for gastric cancer. World J Gastroenterol 12:204–213PubMed Sastre J, Garcia-Saenz JA, Diaz-Rubio E (2006) Chemotherapy for gastric cancer. World J Gastroenterol 12:204–213PubMed
go back to reference Swan R, Miner TJ (2006) Current role of surgical therapy in gastric cancer. World J Gastroenterol 12:372–379PubMed Swan R, Miner TJ (2006) Current role of surgical therapy in gastric cancer. World J Gastroenterol 12:372–379PubMed
go back to reference Takeno S, Noguchi T, Kikuchi R, Sato T, Uchida Y, Yokoyama S (2001) Analysis of the survival period in resectable stage IV gastric cancer. Ann Surg Oncol 8:215–221PubMedCrossRef Takeno S, Noguchi T, Kikuchi R, Sato T, Uchida Y, Yokoyama S (2001) Analysis of the survival period in resectable stage IV gastric cancer. Ann Surg Oncol 8:215–221PubMedCrossRef
go back to reference Wang JY, Hsieh JS, Huang CJ, Huang YS, Huang TJ (1996) Clinicopathologic study of advanced gastric cancer without serosal invasion in young and old patients. J Surg Oncol 63:36–40PubMedCrossRef Wang JY, Hsieh JS, Huang CJ, Huang YS, Huang TJ (1996) Clinicopathologic study of advanced gastric cancer without serosal invasion in young and old patients. J Surg Oncol 63:36–40PubMedCrossRef
go back to reference Wohrer SS, Raderer M, Hejna M (2004) Palliative chemotherapy for advanced gastric cancer. Ann Oncol 15:1585–1595PubMedCrossRef Wohrer SS, Raderer M, Hejna M (2004) Palliative chemotherapy for advanced gastric cancer. Ann Oncol 15:1585–1595PubMedCrossRef
go back to reference Yang L, Parkin DM, Ferlay J, Li L, Chen Y (2005) Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev 14:243–250PubMedCrossRef Yang L, Parkin DM, Ferlay J, Li L, Chen Y (2005) Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev 14:243–250PubMedCrossRef
Metadata
Title
Palliative gastrectomy and chemotherapy for stage IV gastric cancer
Authors
Sheng-Zhang Lin
Hong-Fei Tong
Tao You
Yao-Jun Yu
Wei-Jun Wu
Cong Chen
Wei Zhang
Bing Ye
Chun-Ming Li
Zhi-Qiang Zhen
Jia-Rong Xu
Jun-Liang Zhou
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 2/2008
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-007-0268-z

Other articles of this Issue 2/2008

Journal of Cancer Research and Clinical Oncology 2/2008 Go to the issue