Non-curative gastric resection for patients with stage 4 gastric cancer—a single center experience and current review of literature
| Autor: | Michael Heise, Max Goetz, Falk Rauchfuss, H. Scheuerlein, Utz Settmacher, Yves Dittmar, Karin Jandt |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Kaplan-Meier Estimate Single Center Risk Assessment Cohort Studies Hospitals University Young Adult Postoperative Complications Gastrectomy Stomach Neoplasms Cause of Death Germany Humans Medicine Neoplasm Invasiveness Hospital Mortality Treatment Failure Young adult Stage (cooking) Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over Analysis of Variance Chemotherapy business.industry Age Factors Cancer Retrospective cohort study Middle Aged Vascular surgery medicine.disease Survival Analysis Surgery Female business Abdominal surgery |
| Zdroj: | Langenbeck's Archives of Surgery. 397:745-753 |
| ISSN: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-012-0902-3 |
| Popis: | The majority of patients with gastric cancer present with an advanced stage and, therefore, may not be eligible for curative treatment. The role of non-curative gastric resection in situations other than emergency treatment for life threatening tumor-related complications is still under discussion.Data from 290 consecutive patients with advanced gastric cancer who were treated in our hospital were analyzed. A total of 48 patients underwent primary non-curative gastric resection.The overall survival in the non-curatively resected group was 15 months and 6 months for non-resected patients, respectively (p 0.001). The incidence of tumor-related complications which required intervention was 63% in non-resected patients as compared to 12% in patients who underwent primary non-curative resection. Younger age, less than three tumor locations, and chemotherapy have been identified as prognostic factors for improved survival by univariate analysis. D3 lymph node involvement and chemotherapy were independent prognostic factors in the multivariate analysis. Peritoneal carcinosis did not significantly influence survival in resected patients. Non-curative resection in combination with chemotherapy resulted in longer overall survival than resection alone.Primary non-curative gastric resection can reduce the incidence of severe tumor-related complications and can prolong overall survival in selected subgroups. In particular, younger patients with no more than two tumor locations should be considered for this procedure. |
| Databáze: | OpenAIRE |
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