Nonpalliative Surgical Resection for Gastric Cancer Patients with Distant Metastasis

OBJECTIVE: The purpose of this study was to determine the influence of clinicopathological and treatment factors on survival in gastric cancer patients with distant metastasis after gastrectomy. METHODS: From 1990 to 2002, 111 gastric cancer patients with distant metastasis underwent nonpalliative gastrectomy at the Department of Surgery, Ruijin Hospital, China. Variables including demographic data, clinicopathological characteristics, and type of surgery were analyzed for survival by using univariate and multivariate methods. RESULTS: The median overall survival for all patients was 11.8 months. The overall survival at one-, three-, and five-year was 48.5%, 12.4%, and 5.8%, respectively. Univariate analysis demonstrated that five-year survival of patients without liver metastasis was significantly longer than that of those with liver metastasis (5.3% versus 0%, p = .006). But, multivariate analysis showed that the status of liver metastasis, as well as the other variables including gender, age, location of tumor, Borrmann type, depth of tumor invasion, lymph node involvement, peritoneal dissemination, number of metastatic sites, pathological differentiation, and types of gastrectomy, was not an independent prognostic factor associated with survival. CONCLUSIONS: Long-term survival for gastric cancer patients with distant metastasis is very poor after gastrectomy. The multivariate analysis failed to determine the independent factors of improved survival. So, only highly selected candidates should be considered for management with surgical resection.