Advisability of Palliative Resections in Incurable Advanced Gastric Cancer

• Authors: Tariq Al-Amawi , Małgorzata Świder-Al-Amawi , Mirosław Halczak , Piotr Wojtasik , Józef Kładny
• Languages of publication: EN

Abstracts

EN

Effective treatment is the primary objective of surgeon in the treatment of advanced gastric cancer. Poor prognosis and significant advancement of gastric cancer at the time of diagnosis are decisive factors for the only possible surgical management method being palliative procedures.The aim of the study was the evaluation of the value of palliative resection procedures in patients with advanced gastric cancer.Material and methods. The subject in the study was a group of 105 patients with gastric adenocarcinoma at stage 4 of advancement, in whom curative treatment was not possible. The group constituted 44.5% of patients operated on due to gastric cancer at the Department of General and Oncological Surgery, PUM, in the years 1998-2009. The patients were divided into two groups: the first one comprised 44 patients post palliative resections, the second - 61 patients post non-resection procedures. The subject of analysis were early and late treatment results post palliative resections, and they were compared with the treatment results post non-resection procedures.Results. Palliative resections were performed in 44 patients (19 females and 25 males), while in 61 patients (38 males and 23 females) non-resection procedures were performed. Postoperative complications were observed in 25% of patients in the group post palliative resections and in 11.5% in the group of patients without the resection of primary focus. In-hospital mortality stood at 4.5% in the group post palliative resections and 4.8% in the group post non-resection procedures. The percentage of 1-year and 4-year survival post palliative resections stood at 43% and 8.8%, respectively. In the group without the resection of primary focus, 16% survived 1 year and nobody survived 2 years. Conclusions. Palliative resections improve the survival of patients with incurable gastric cancer and should be considered if only the loco-regional conditions are favourable.

Keywords

EN

gastric cancer; palliative resections; non-resection procedures

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2011
• Volume: 83
• Issue: 8
• Pages: 449-456

Dates

published

1 - 8 - 2011

online

4 - 10 - 2011

Contributors

author

Tariq Al-Amawi

• Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin

author

Małgorzata Świder-Al-Amawi

• Department of Histology and Embryology, Pomeranian Medical University in Szczecin

author

Mirosław Halczak

• Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin

author

Piotr Wojtasik

• Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin

author

Józef Kładny

• Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin

References

• Plummer M, Franceschi S, Muñoz N: Epidemiology of gastric cancer. IARC Sci Publ. 2004; 157: 311-26.
• Ferlay J, Shin HR, Bray F et al.: GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from:
• Krajowa Baza Danych Nowotworowych. Zakład Epidemiologii i Prewencji Nowotworów Centrum Onkologii - Instytut.
• Hartgrink HH, Jansen EP, van Grieken NC et al.: Gastric cancer. Lancet 2009; 374(9688): 477-90.
• Samarasam I, Chandran BS, Sitaram V et al.: Palliative gastrectomy in advanced gastric cancer: is it worthwhile? ANZ J Surg 2006; 76(1-2): 60-63.[Crossref]
• Bozzetti F, Bonfanti G, Audisio RA et al.: Prognosis of patients after palliative surgical procedures for carcinoma of the stomach. Surg Gynecol Obstet 1987; 164(2): 151-54.
• Haugstvedt T, Viste A, Eide GE i wsp. The survival benefit of resection in patients with advanced stomach cancer: the Norwegian multicenter experience. Norwegian Stomach Cancer Trial. World J Surg 1989; 13(5): 617-22.[Crossref]
• Lawrence W J r, McNeer G: The effectiveness of surgery for palliation of incurable gastric cancer. Cancer 1958; 11(1): 28-32.[Crossref][PubMed]
• Swan R, Miner TJ: Current role of surgical therapy in gastric cancer. World J Gastroenterol 2006 21; 12(3): 372-79.
• Doglietto GB, Pacelli F, Caprino P et al.: Palliative surgery for far-advanced gastric cancer: a retrospective study on 305 consecutive patients. Am Surg 1999; 65(4): 352-55.
• Cunningham SC, Schulick RD: Palliative management of gastric cancer. Surg Oncol 2007; 16(4): 267-75.[PubMed][Crossref]
• Hartgrink HH, Putter H, Klein Kranenbarg E et al.: Dutch Gastric Cancer Group. Value of palliative resection in gastric cancer. Br J Surg 2002; 89(11): 1438-43.
• Miner TJ, Jaques DP, Karpeh MS et al.: Defining palliative surgery in patients receiving noncurative resections for gastric cancer. J Am Coll Surg 2004; 198(6): 1013-21.
• Saidi RF, ReMine SG, Dudrick PS et al.: Is there a role for palliative gastrectomy in patients with stage IV gastric cancer? World J Surg 2006; 30(1): 21-27.[Crossref]
• Huang KH, Wu CW, Fang WL et al.: Palliative resection in noncurative gastric cancer patients. World J Surg 2010; 34(5): 1015-21.[Crossref]
• Popiela T, Kulig J, Karcz D, Czupryna A: Zasady postępowania chirurgicznego w raku żołądka; zabiegi paliatywne. W: Popiela T (red.) Rak żołądka. PZWL, Warszawa 1987; 7: 172-176.
• Popiela T: Nowotwory żołądka. W: Szawłowski A, Szmidt J (red.) Zasady diagnostyki i chirurgicznego leczenia nowotworów w Polsce. Fundacja PPCh 2003; 10: 190-94.
• Okines A, Verheji M, Allum W, Cunnigham D, Cervantes A: ESMO Guidelines Working Group: Gastric cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21 (suppl 5): v50-v54.[Crossref]
• National Comprehensive Cancer Network. Gastric cancer NCCN clinical practice guidelines in oncology. 2011; version I.2011
• Guyatt GH: Evidence-based medicine. ACP J Club (Annals of Internal Medicine) 1991; 114(suppl 2): A-16
• Van Custem E_i wsp. Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy in first-line human epidermoid growth factor receptor 2 positive advanced cancer. J Clin Oncol 2009; (27 suppl), abstract ASCO Congress 2409.
• Petrelli N et al.: Clinical cancer cdvances 2009: Major research advances in cancer treatment, prevention and screening - a report from the American Society of Clinical Oncology - ASCO. J Clin Oncol 2009; 27: 1-18.
• Okines A, Cunningham D: Trastuzumab in gastric cancer. Eur J Cancer 2010; 46: 1949-59.[PubMed][Crossref]
• Jørgensen JT. Targeted HER2 treatment in advanced gastric cancer. Oncology 2010; 78: 26-33.
• New Hope for advanced gastric cancer - Lancet Oncology 2010; vol 11: 211
• Popiela T i wsp.: Zasady leczenia raka żołądka. "Polski konsensus" - ustalony w Krakowie w dniu 30 maja 1997. Pol Przegl Chir 1998; 70, suplement.

Identifiers

DOI

10.2478/v10035-011-0070-0