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Palliative surgery in metastatic gastric cancer: analysis (2007–2021)
  1. Rajendran Theakarajan,
  2. Vageesh B G,
  3. Saravanan M N and
  4. Anil Agarwal
  1. Gastrointestinal Surgery, GB Pant Hospital, New Delhi, India
  1. Correspondence to Dr Vageesh B G; bgvageesh{at}yahoo.com

Abstract

Objective Patients with metastatic gastric cancer (MGC) may require palliative surgery to manage complications such as obstruction or bleeding. While the role of stenting in MGC is clear, the role of palliative surgery in MGC shows conflicting results.

Methods We retrospectively reviewed clinical data of patients with MGC treated at our institution between January 2007 and December 2021. The clinical outcomes of patients who underwent palliative surgery are analysed in this review.

Results Gastrojejunostomy (GJ) and palliative gastrectomy were performed in 48 and 28 patients, respectively. The median overall survival in the GJ and palliative gastrectomy groups were 9.25 and 11.25 months, respectively (p=0.21). On subgroup analysis, we found that the patients who were diagnosed with MGC intraoperatively had better survival compared with preoperatively diagnosed patients even though it was statistically not significant. The complication rates following GJ and palliative gastrectomy were 6% and 7%, respectively.

Conclusion Both palliative gastrectomy and GJ offer similar results to endoscopic stenting, as reported in the literature. Surgical palliative options continue to be relevant in selected cases due to lower rates of repeat interventions and reduced hospital visits, making them a one-time solution for patients, especially in resource-constrained settings.

  • Palliative Care
  • Gastrointestinal (upper)
  • Supportive care
  • Dysphagia

https://doi.org/10.1136/spcare-2024-005225

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    Footnotes

    • Contributors TR is the guarantor. TR and VBG designed the study and analysed the data and wrote the manuscript. SMN and AA gave the core concept and helped in designing the study, they also verified the data and corrected the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.