Survival of patients with advanced gastric cancer subjected to palliative surgery

Background: Most patients with gastric cancer consult when the tumor is an advanced stage. Aim: To assess the survival of patients with gastric cancer in stage IIIc or IV subjected to surgery. Patients and Methods: Prospective study of patients with gastric cancer in stages IIIc (spreading to nearby organs or serosa) or IV (spreading to distant organs), who consulted between 2004 and 2012. A surgical exploration was carried out in all patients performing a palliative total or subtotal gastrectomy, a gastrojejunal anastomosis or only an exploration. Twenty five patients received adjuvant chemotherapy. All were followed until their death. Results: A surgical resection was performed in 61 patients (64 percent) with an operative mortality of 5 and 0 percent for total and subtotal gastrectomy, respectively. The mortality of non-resected patients was 6.4 percent with a maximal survival of 15 months after surgery. No significant differences in survival were observed between patients with hepatic or peritoneal metastases. Adjuvant chemotherapy significantly improved survival among patients subjected to gastric resection. Conclusions: Among patients with gastric cancer, palliative gastrectomy may improve quality of life and adjuvant chemotherapy apparently improves survival.