GASTRIC-CANCER WITH METASTASES TO THE DISTANT PERITONEUM - A 20-YEAR SURGICAL EXPERIENCE

BACKGROUND/AIMS: The efficacy of palliative gastrectomy in gastric can cer with peritoneal metastases remains uncertain. The aim of the prese nt study was to evaluate the benefits of gastrectomy on the postoperat ive course of patients with gastric cancer and simultaneous metastases to the distant peritoneum. METHODOLOGY: A total of 122 patients who h ad gastric cancer and metastases to the distant peritoneum were studie d with respect to survival. RESULTS: The extent of peritoneal metastas es did not significantly affect the prognosis. Moreover, multivariate analysis indicated that surgery without gastrectomy was the only signi ficant prognostic factor (relative risk, 2.587). CONCLUSIONS: Our resu lts suggest that the decision to perform gastrectomy does not depend o n the extent of peritoneal metastasis in gastric cancer. Furthermore, palliative gastrectomy, if feasible, seems to have a beneficial effect on the postoperative course and is indicated for patients regardless of metastasis to the peritoneum, if the primary tumor is surgically re sectable and there is no evidence of liver metastasis.