1. Palliative Gastrectomy versus Gastrojejunostomy for advanced Gastric cancer with outlet obstruction: a propensity score matching analysis
- Author
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Xi-Cheng Wang, Xiao-Jiang Chen, Run-Cong Nie, Zhou-Kai Zhao, Zhiwei Zhou, Yi-Cheng Wei, Hong Yu, Guo-Ming Chen, and Tian-Qi Luo
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Advanced gastric cancer ,medicine.medical_treatment ,Gastric Bypass ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Quality of life ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,Genetics ,medicine ,Humans ,Overall survival ,Risk factor ,Propensity Score ,Palliative gastrectomy ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Gastric Outlet Obstruction ,Palliative Care ,Postoperative complication ,Cancer ,Gastric outlet obstruction ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Outlet obstruction ,Propensity score matching ,030211 gastroenterology & hepatology ,Female ,business ,Gastrojejunostomy ,Research Article - Abstract
Background Gastric outlet obstruction (GOO) is a late complication of advanced gastric cancer, and it is controversial how to select the therapeutic strategies: gastrojejunostomy and palliative gastrectomy? Therefore, this study was to compare the surgical and survival outcomes of gastrojejunostomy and palliative gastrectomy. Methods In total, 199 gastric cancer patients with outlet obstruction treated by surgery between January 2000 and December 2015 at Sun Yat-sen University Cancer Center were retrospectively reviewed. Patients were divided into gastrojejunostomy group and palliative gastrectomy group. Propensity score matching (PSM) was performed to balance the selection bias. Results After 1:1 PSM, a total of 104 patients were included for final analysis. The median overall survival (OS) times in the gastrojejunostomy group and palliative gastrectomy group were 8.50 and 11.87 months, respectively (P = 0.243). The postoperative complication rates in the gastrojejunostomy group and palliative gastrectomy group were 19.23% (10/52) and 17.31% (9/52), respectively (P = 0.800), and no treatment-related death was observed. Multivariate analysis showed that periton0eal seeding (P = 0.014) and chemotherapy (P Conclusions Our results indicated that although the surgical complications of palliative gastrectomy were manageable, it showed no survival benefit. Therefore, relieving obstruction symptom, improving patients’ quality of life and creating better conditions for chemotherapy appear to be the main therapeutic strategies for advanced gastric cancer with GOO.
- Published
- 2021