Therapeutic significance of palliative operations for gastric cancer for survival and quality of life

Background and Objectives: There have been few reports on the objective assessment of quality of life (QOL) in patients with gastric cancer following palliative operations. The benefit of a palliative operation for survival and QOL of patients with gastric cancer is not clear. Methods Survival and hospital‐free survival (HFS), which is considered to be one objective indicator of QOL, were studied in 95 patients undergoing palliative operations for gastric cancer. Univariate and multivariate analyses were used to determine the clinicopathologic factors potentially related to survival of patients. Results In univariate analysis, palliative gastrectomy and absence of peritoneal dissemination were significantly correlated with better survival. The significance of palliative gastrectomy for survival was, therefore, evaluated for various degrees of peritoneal dissemination: P0, no dissemination; P1, metastasis to the adjacent peritoneum; P2, a few scattered metastases to the distant peritoneum; and P3, numerous metastases. Survival and achievement of HFS for 3 months or longer were higher following palliative gastrectomy than gastrojejunostomy. Among gastrectomies, however, total gastrectomy performed in patients with P2 or P3 showed a poorer outcome for survival and HFS than total gastrectomy performed with P0 or P1 and distal gastrectomy. Conclusions As a palliative measure, gastrojejunostomy and total gastrectomy performed with P2 or P3 peritoneal dissemination had no beneficial effect on the prolongation of survival or improvement of QOL of patients with gastric cancer. J. Surg. Oncol. 1998;69:41–44. © 1998 Wiley‐Liss, Inc.