Palliative Gastrectomy versus Gastrojejunostomy for advanced Gastric cancer with outlet obstruction: a propensity score matching analysis

Autor: Xi-Cheng Wang, Xiao-Jiang Chen, Run-Cong Nie, Zhou-Kai Zhao, Zhiwei Zhou, Yi-Cheng Wei, Hong Yu, Guo-Ming Chen, Tian-Qi Luo
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
Advanced gastric cancer
medicine.medical_treatment
Gastric Bypass
lcsh:RC254-282
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Quality of life
Surgical oncology
Gastrectomy
Stomach Neoplasms
Genetics
medicine
Humans
Overall survival
Risk factor
Propensity Score
Palliative gastrectomy
Aged
Retrospective Studies
Aged
80 and over
business.industry
Gastric Outlet Obstruction
Palliative Care
Postoperative complication
Cancer
Gastric outlet obstruction
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Surgery
Oncology
030220 oncology & carcinogenesis
Outlet obstruction
Propensity score matching
030211 gastroenterology & hepatology
Female
business
Gastrojejunostomy
Research Article
Zdroj: BMC Cancer, Vol 21, Iss 1, Pp 1-8 (2021)
BMC Cancer
ISSN: 1471-2407
Popis: Background Gastric outlet obstruction (GOO) is a late complication of advanced gastric cancer, and it is controversial how to select the therapeutic strategies: gastrojejunostomy and palliative gastrectomy? Therefore, this study was to compare the surgical and survival outcomes of gastrojejunostomy and palliative gastrectomy. Methods In total, 199 gastric cancer patients with outlet obstruction treated by surgery between January 2000 and December 2015 at Sun Yat-sen University Cancer Center were retrospectively reviewed. Patients were divided into gastrojejunostomy group and palliative gastrectomy group. Propensity score matching (PSM) was performed to balance the selection bias. Results After 1:1 PSM, a total of 104 patients were included for final analysis. The median overall survival (OS) times in the gastrojejunostomy group and palliative gastrectomy group were 8.50 and 11.87 months, respectively (P = 0.243). The postoperative complication rates in the gastrojejunostomy group and palliative gastrectomy group were 19.23% (10/52) and 17.31% (9/52), respectively (P = 0.800), and no treatment-related death was observed. Multivariate analysis showed that periton0eal seeding (P = 0.014) and chemotherapy (P Conclusions Our results indicated that although the surgical complications of palliative gastrectomy were manageable, it showed no survival benefit. Therefore, relieving obstruction symptom, improving patients’ quality of life and creating better conditions for chemotherapy appear to be the main therapeutic strategies for advanced gastric cancer with GOO.
Databáze: OpenAIRE
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