Palliative surgery for far-advanced gastric cancer: A retrospective study on 305 consecutive patients

Few reports of the Western countries have investigated the value of palliat ive surgery for stomach cancer. The aim of this study was to evaluate the r esults of palliative surgery in a large series of patients affected by gast ric carcinoma, consecutively treated by the same surgical team. The hospita l records of 305 patients affected by gastric cancer who did not undergo su rgical treatment or who underwent a palliative surgical procedure at our un it between 1981 and 1995 were reviewed. Univariate and multivariate analyse s were used to calculate the 5-year survival probabilities with respect to the following variables: demographic data, tumor location and gross appeara nce, spread of the disease, histological type according to P. Lauren, and t ype of treatment. Multivariate logistic regression analysis showed that res ectional surgery and tumor spread limited to local sites were independently associated with better survival. The study indicates that even though ther e are host-related factors that govern survival in far-advanced stomach can cer, the type of surgery can have a significant effect on prognosis; resect ional surgery-should be undertaken whenever possible in such patients.