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Gastric carcinoma: when is palliative gastrectomy justified?

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Oncology Reviews

Abstract

Gastric carcinoma is frequently diagnosed with an advanced stage of non-curable tumor growth characterized by infiltration of the gastric serosa, peritoneal tumor spread and/or metastases within lymph nodes and liver. Currently, there is a controversy on the value of palliative resection with regard to the safety and benefit to the patient outcome. Based on the available literature, this overview summarizes the various aspects and interprets the limited data on the palliative resection of gastric carcinoma. It turns out that the available study results may indicate potential for an improved quality of life and a prolongation of survival if an acceptable morbidity and mortality are present.

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References

  1. Beller S, Schlag PM (2006) Significance of palliative resection of gastrointestinal tumors. Chirurg 77:219–225

    Article  CAS  PubMed  Google Scholar 

  2. Bonenkamp JJ, Sasako M, Hermans J, van de Velde CJ (2001) Tumor load and surgical palliation in gastric cancer. Hepatogastroenterology 48:1219–1221

    CAS  PubMed  Google Scholar 

  3. Cho BC, Jeung HC, Choi HJ, Rha SY, Hyung WJ, Cheong JH, Noh SH, Chung HC (2007) Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer: a 15-year experience at a single institute. J Surg Oncol 95:461–468

    Article  PubMed  Google Scholar 

  4. Conroy T, Marchal F (2006) Blazeby JM. Quality of life in patients with oesophageal and gastric cancer: an overview oncology 70:391–402

    Google Scholar 

  5. Dittmar Y, Voigt R, Heise M, Rabsch A, Jandt K, Settmacher U (2009) Indications and results of palliative gastric resection in advanced gastric carcinoma. Zbl Chir 134:77–82

    Article  CAS  PubMed  Google Scholar 

  6. Fujimura T, Ishii K, Oyama K, Miyashita T, Kinami S, Ninomiya I, Kitagawa H, Fushida S, Nishimura G, Kayahara M, Shimizu K, Ohta T, Miwa K (2003) A new scoring system for peritoneal metastasis in gastric cancer. Gastric Cancer 6:146–152

    Article  PubMed  Google Scholar 

  7. Goel A, Khandelwal C (2006) Role of palliative gastrectomy in locally advanced gastric cancer: experience of 313 cases. In: ASCO-meeting: gastrointestinal cancers symposium 2006, Abstract No. 39. http://www.asco.org. Accessed 15 Jan 2008

  8. Green D, Ponce de Leon S, Leon-Rodriguez E, Sosa-Sanchez R (2002) Adenocarcinoma of the stomach: univariate and multivariate analysis of factors associated with survival. Am J Clin Oncol 25:84–89

    Article  PubMed  Google Scholar 

  9. Hanazaki K, Sodeyama H, Mochizuki Y, Igarashi J, Yokoyama S, Sode Y, Wakabayashi M, Kawamura N, Miayzaki T (2001) Palliative gastrectomy for advanced gastric cancer. Hepatogastroenterology 48:285–289

    CAS  PubMed  Google Scholar 

  10. Hartgrink HH, Putter H, Klein Kranenbarg E, Bonenkamp JJ, van de Velde CJ (2002) Value of palliative resection in gastric cancer. Br J Surg 89:1438–1443

    Article  CAS  PubMed  Google Scholar 

  11. Haugstvedt T, Viste A, Eide GE, Söreide O (1989) The survival benefit of resection in patients with advanced stomach cancer: the Norwegian multicenter experience. World J Surg 13:617–621

    Article  CAS  PubMed  Google Scholar 

  12. Heemskerk VH, Lentze F, Hulsewe KWE, Hoofwijk TGM (2007) Gastric carcinoma: review of the results of treatment in a community teaching hospital. World J Surg Oncol 5:81–88

    Article  PubMed  Google Scholar 

  13. Ikeguchi M, Oka S, Gomyo Y, Tsujitani S, Maeta M, Kaibara N (2001) Postoperative morbidity and mortality after gastrectomy for gastric carcinoma. Hepatogastroenterology 48:1517–1520

    CAS  PubMed  Google Scholar 

  14. Isosaki H, Okajima K, Kawashima Y, Yamada S, Nakata E, Nishimura J (1993) Relative non-curative resection of gastric cancer: a review of 106 cases. Jpn J Cancer Clin 39:657–662

    Google Scholar 

  15. Jaquet P, Sugarbaker PH (1996) Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res 82:359–374

    Google Scholar 

  16. Kahlke V, Bestmann B, Schmid A, Doniec JM, Küchler T, Kremer B (2004) Palliation of metastatic gastric cancer: impact of preoperative symptoms and the type of operation on survival and quality of life. World J Surg 28:369–375

    Article  PubMed  Google Scholar 

  17. Kan YF, Zheng Y, Li SY, Liu J, Chen G, Han DD, Gao ZG (2005) Postoperative mortality after gastrectomy for gastric cancer: analysis of 1142 cases. Zhongua Wei Chang Wai Ke Za Zhi 8:422–424

    Google Scholar 

  18. Kikuchi S, Arai Y, Morise M, Kobayashi N, Tsukamoto H, Shimao H, Sakakibara Y, Hiki Y, Kakita A (1998) Gastric cancer with metastases to the distant peritoneum: a 20-year surgical experience. Hepatogastroenterology 45:1183–1188

    CAS  PubMed  Google Scholar 

  19. Kim DY, Joo JK, Park YK, Ryu SY, Kim YJ, Kim SK, Lee JH (2008) Is palliative resection necessary for gastric carcinoma patients? Langenbecks Arch Surg 393(1):31–35

    Article  PubMed  Google Scholar 

  20. Kirchner R, Stützer H, Farthmann EH (1992) Palliative interventions. Langenbecks Arch Chir Suppl Kongressbd 142–146

  21. Kunisaki C, Shimada H, Akiyama H, Nomura M, Matsuda G, Ono H (2003) Survival benefit of palliative gastrectomy in advanced incurable gastric cancer. Anticancer Res 23:1853–1858

    PubMed  Google Scholar 

  22. Kunisaki C, Shimada H, Nomura M, Matsuda G, Otsuka Y, Ono H, Akiyama H (2005) Therapeutic strategy for scirrhous type of gastric cancer. Hepatogastroenterology 52:314–318

    PubMed  Google Scholar 

  23. Kunisaki C, Makino H, Takagawa R, Oshima T, Nagano Y, Fujii S, Otsuka Y, Akijama H, Ono HA, Kosaka T, Ichikawa Y, Shimada H (2008) Impact of palliative gastrectomy in patients with incurable advanced gastric cancer. Anticancer Res 28:1309–1315

    PubMed  Google Scholar 

  24. Lee SS, Lee JL, Ryu MH, Chang HM, Kim TW, Kang HJ, Kim WK, Lee JS, Kang YK (2007) Combination chemotherapy with Capecitabine (X) and Cisplatin (P) as first line treatment in advanced gastric cancer: experience of 223 patients with prognostic factor analysis. Jpn J Clin Oncol 37:30–37

    Article  PubMed  Google Scholar 

  25. Maekawa S, Saku M, Maehara Y, Sadanaga N, Ikejiri K, Anai H (1996) Surgical treatment for advanced gastric cancer. Hepatogastroenterology 43:178–186

    CAS  PubMed  Google Scholar 

  26. Meyer L, Meyer F, Dralle H, Ernst M, Lippert H, Gastinger I (2005) Insufficiency risk of esophagojejunal anastomosis after total abdominal gastrectomy for gastric carcinoma. Langenbecks Arch Surg 390:510–516

    Article  CAS  PubMed  Google Scholar 

  27. Miner TJ, Jaques DP, Shriver CD (2002) A prospective evaluation of patients undergoing surgery for the palliation of an advanced malignancy. Ann Surg Oncol 9:696–703

    Article  PubMed  Google Scholar 

  28. Monson JR, Donohue JH, McIlrath DC, Farnell MB, Ilstrup DM (1991) Total gastrectomy for advanced cancer. A worthwhile palliative procedure. Cancer 68:1863–1868

    Article  CAS  PubMed  Google Scholar 

  29. Msika S, Tazi MA, Benhamiche AM, Couillault C, Harb M, Faivre J (1997) Population-based study of diagnosis, treatment and prognosis of gastric cancer. Br J Surg 84:1474–1478

    Article  CAS  PubMed  Google Scholar 

  30. Nazli O, Yaman I, Tansug T, Isgüder AS, Bozdag AD, Bölükbasi H (2007) Palliative surgery for advanced stage (stage IV) gastric adenocarcinoma. Hepatogastroenterology 54:298–303

    PubMed  Google Scholar 

  31. Ng EK, Wong SK, Chan AC, Lee DW (2002) Palliative gastrectomy improves survival in patients with stomach cancer having peritoneal metastases detected on staging laparoscopy—a prospective follow-up study. The Society for Surgery of the Alimentary Tract, Abstracts Digestive Disease Week 2002, Abstract ID: #102464

  32. Onate-Ocana LF, Mendez-Cruz G, Hernandez-Ramos R, Becker M, Carillo JF, Herrera-Goepfert R, Aiello-Crocifoglio V, Ochoa-Carillo F, Beltran-Ortega A (2007) Experience of surgical morbidity after palliative surgery inpatients with gastric carcinoma. Gastric Cancer 10:215–220

    Article  PubMed  Google Scholar 

  33. 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 69:41–44

    Article  CAS  PubMed  Google Scholar 

  34. Pacelli F, Papa V, Rosa F, Tortorelli AP, Sanchez AM, Covino M, Bossola M, Doglietto GB (2008) Four hundred consecutive total gastrectomies for gastric cancer: a single institution experience. Arch Surg 143:769–775

    Article  PubMed  Google Scholar 

  35. Saidi RF, ReMine SG, Dudrick PS, Hanna NN (2005) Is there a role for palliative gastrectomy in patients with stage IV gastric cancer? World J Surg 30:21–27

    Article  Google Scholar 

  36. Samarasam I, Chandran BS, Sitaram V, Perakath B, Nair A, Mathew G (2006) Palliative gastrectomy in advanced gastric cancer: is it worthwhile? ANZ J Surg 76:60–63

    Article  PubMed  Google Scholar 

  37. Schwarz RE, Zagala-Nevarez K (2002) Gastrectomy circumstances that influence early postoperative outcome. Hepatogastroenterology 49:1742–1746

    PubMed  Google Scholar 

  38. Siewert JR, Böttcher K, Roder JD, Fink U (1993) Palliative treatment from the surgical point of view. In: Nishi M, Ichikawa H, Nakajima T, Maruyama K, Tahara E (eds) Gastric cancer therapy. Springer, Berlin, pp 379–391

  39. Siewert JR, Fink U, Sendler A, Becker K, Böttcher K, Feldmann HJ, Höfler H, Mueller J, Molls M, Nekarda H, Roder JD, Stein HJ (1997) Gastric cancer. Curr Probl Surg 34:835–942

    Article  CAS  PubMed  Google Scholar 

  40. Sugarbaker PH, Yonemura Y (2000) Clinical pathway for the management of resectable gastric cancer with peritoneal seeding: best palliation with a ray of hope for cure. Oncology 58:96–107

    Article  CAS  PubMed  Google Scholar 

  41. Tas F, Aykan NF, Aydiner A, Uygun K, Basaran M, Camlica H, Topuz E (2000) The roles of chemotherapy and surgery in gastric carcinoma and the influence of prognostic factors on survival. Am J Clin Oncol 23:53–57

    Google Scholar 

  42. Vickery CW, Blazeby JM, Conroy T, Johnson CD, Alderson D (2000) Development of an EORTC module to improve quality of life assessment in patients with gastric cancer. Br J Surg 87:362–373

    Article  Google Scholar 

  43. Wang CS, Hsieh CC, Chao TC, Jan YY, Jeng LB, Hwang TL, Chen MF, Chen PC, Chen JS, Hsueh S (2002) Resectable gastric cancer: operative mortality and survival analysis. Chang Gung Med J 25:216–227

    PubMed  Google Scholar 

  44. Wu CW, Lo SS, Shen KH, Hsieh MC, Liu WY, Peng FK (2000) Surgical mortality, survival and quality of life after resection for gastric cancer in the elderly. World J Surg 24:465–472

    Article  CAS  PubMed  Google Scholar 

  45. Yook JH, Oh ST, Kim BS (2005) Clinicopathological analysis of Borrmann type IV gastric cancer. Cancer Res Treat 37:87–91

    Article  PubMed  Google Scholar 

  46. Yonemura Y, Endo Y, Obata T, Sasaki T (2007) Recent advances in the treatment of peritoneal dissemination of gastrointestinal cancers by nucleoside antimetabolites. Cancer Sci 98:11–18

    Article  CAS  PubMed  Google Scholar 

  47. Zhang XF, Huang CM, Lu HS, Wu XY, Wang C, Guang GX, Zhang JZ, Zheng CH (2004) Surgical treatment and prognosis of gastric cancer in 2613 patients. World J Gastroenterol 10:3405–3408

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General, Abdominal and Vascular Surgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany

    Hubert Scheidbach, Hans Lippert & Frank Meyer

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  1. Hubert Scheidbach
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  2. Hans Lippert
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  3. Frank Meyer
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Correspondence to Hubert Scheidbach.

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Scheidbach, H., Lippert, H. & Meyer, F. Gastric carcinoma: when is palliative gastrectomy justified?. Oncol Rev 4, 127–132 (2010). https://doi.org/10.1007/s12156-010-0046-z

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  • DOI: https://doi.org/10.1007/s12156-010-0046-z

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