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. 2022 Jan 13;14(2):388.
doi: 10.3390/cancers14020388.

Distal Gastrectomy for Symptomatic Stage IV Gastric Cancer Contributes to Prognosis with Acceptable Safety Compared to Gastrojejunostomy

Nobuaki Fujikuni  1 , Kazuaki Tanabe  2 , Minoru Hattori  3 , Yuji Yamamoto  4 , Hirofumi Tazawa  5 , Kazuhiro Toyota  6 , Noriaki Tokumoto  7 , Ryuichi Hotta  8 , Senichiro Yanagawa  1 , Yoshihiro Saeki  9 , Yoichi Sugiyama  10 , Masahiro Ikeda  11 , Masayuki Shishida  12 , Toshikatsu Fukuda  13 , Keisuke Okano  14 , Masahiro Nishihara  15 , Hideki Ohdan  9 , On Behalf Of Hiroshima Surgical Study Group Of Clinical Oncology HiSCO
Affiliations

Distal Gastrectomy for Symptomatic Stage IV Gastric Cancer Contributes to Prognosis with Acceptable Safety Compared to Gastrojejunostomy

Nobuaki Fujikuni et al. Cancers (Basel). .

Abstract

Background: The prognostic prolongation effect of reduction surgery for asymptomatic stage IV gastric cancer (GC) is unfavorable; however, its prognostic effect for symptomatic stage IV GC remains unclear. We aimed to compare the prognosis of gastrectomy and gastrojejunostomy for symptomatic stage IV GC.

Methods: This multicenter retrospective study analyzed record-based data of patients undergoing palliative surgery for symptomatic stage IV GC in the middle or lower-third regions between January 2015 and December 2019. Patients were divided into distal gastrectomy and gastrojejunostomy groups. We compared clinicopathological features and outcomes after propensity score matching (PSM).

Results: Among the 126 patients studied, 46 and 80 underwent distal gastrectomy and gastrojejunostomy, respectively. There was no difference in postoperative complications between the groups. Regarding prognostic factors, surgical procedures and postoperative chemotherapy were significantly different in multivariate analysis. Each group was further subdivided into groups with and without postoperative chemotherapy. After PSM, the data of 21 well-matched patients with postoperative chemotherapy and 8 without postoperative chemotherapy were evaluated. Overall survival was significantly longer in the distal gastrectomy group (p = 0.007 [group with postoperative chemotherapy], p = 0.02 [group without postoperative chemotherapy]).

Conclusions: Distal gastrectomy for symptomatic stage IV GC contributes to prognosis with acceptable safety compared to gastrojejunostomy.

Keywords: distal gastrectomy; gastric cancer; gastrojejunostomy; palliative surgery; stage IV.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves of distal gastrectomy and gastrofejunostomy for stage IV gastric cancer (a) all cases, (b) with chemotherapy and (c) without chemotherapy.
See this image and copyright information in PMC

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