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Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1782
De Stefano A., Roviello F., Marrelli D., Messano A., Fotia G., Pinto E.
Background. In this study, the authors report their experience on the surgical treatment of highly advanced gastric carcinoma.
Methods. Four-hundred patients operated on between 1977 and 1994 were considered: of these, 174 underwent a simple laparotomy, 76 a bypass, and 150 a resection; this last group was subdivided into 98 relatively non-curative resections, and 52 absolutely non-curative resection.
Results. Operative mortality was observed in 38 patients (9.5%): 13 cases (7.5%) following laparotomy, 11 cases (14.5%) following bypass, and 14 cases (9.3%) following resective surgery (p=n.s.). Morbidity rates were 11.5% (20 cases), 22.4% (17 cases), and 34.7% (52 cases) respectively (p<0.001); overall morbidity rate was 22.2%. An improvement in quality of life was observed in 60% of resected cases, vs 30% following laparotomy or bypass. In patients treated with non-resective procedures, median survival was 6.75 months, and survival rates were 11, 2 and 1% at one, two and five years respectively. In resected cases, a median survival of 11 months, and 45, 25 and 7% survival rates at one, two and five years were observed. After relatively non-curative resections, these values rose to 56, 33 and 10% respectively, and median survival was 15.1 months.
Conclusions. From these results, the conclusion is drawn that in locoregional or distant spread gastric carcinoma, resective procedures provides better quality of life and longer survival time than non-resective procedures, with a comparable operative risk.