POSTOPERATIVE CHEMOTHERAPY MAY IMPROVE PROGNOSIS IN UNRESECTABLE GASTRIC-CANCER

We have retrospectively evaluated to prognosis of patients with unrese ctable gastric cancer (UGC) and the effect of postoperative chemothera py on that prognosis. One hundred patients who died of UGC included 37 patients who received postoperative chemotherapy (chemotherapy group) and 63 patients who did not receive postoperative chemotherapy (contr ol group). Chemotherapy regimens were as follows: intravenous mitomyci n (MMC) plus 5-fluorouracil (5-FU) (n = 15), oral 5-FU alone (n = 10), intravenous methotrexate (MTX) plus 5-FU (n = 8), intravenous cisplat in plus 5-FU (n = 2), and hepatic arterial infusion of 5-FU plus oral 5-FU (n = 2). No prior chemotherapy or radiation therapy was given. Al l patients' cancers were stage IV. Median survival of the chemotherapy group (238 days) was significantly longer than the control group (137 days). The 1-year survival rate in the treated group was 19.0% but on ly 2.4% in the control group (p < 0.01). Patients with palliative gast rojejunostomy did not survive significantly longer than those having l aparotomy alone or ileal tube insertion. We conclude that the prognosi s for patients with UGC remains very poor, but postoperative chemother apy may contribute to prolonged survival in patients with UGC.