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KMID : 0914820090090040231
Journal of the Korean Gastric Cancer Association
2009 Volume.9 No. 4 p.231 ~ p.237
The Significance of Prophylactic Gastrojejunostomy for Patients with Unresectable Stage IV Gastric Cancer
Kim Hwan-Soo

Kim Chong-Suk
Kim Jong-Han
Mok Young-Jae
Park Sung-Soo
Park Sung-Heum
Jang You-Jin
Kim Seung-Joo
Abstract
Purpose: The aim of this study was to evaluate the significance of palliative gastrojejunostomy for treating patients with unresectable stage IV gastric cancer, and as compared with laparotomy for treating patients with incurable gastric cancer.

Materials and Methods : We retrospectively studied 167 patients who could not undergo resection without obstruction at Korea University Hospital from 1984 to 2007. They were classified into two groups, one that underwent palliative gastrojejnostomy (the bypass group, n=62) and one that underwent explo-laparotomy (the O&C group, n=105), and the clinical data and operative outcomes were compared according to the groups.

Results: For the clinical characteristics, there were no differences of age, gender and liver metastasis between the bypass group and the explo-laparotomy group, but there was a significant different for the presence of peritoneal metastasis (P=0.001). There was no difference between two groups for the postoperative mortality and morbidity. For the postoperative outcomes, the duration of the hospital stay (29.25 vs 16.67) and the frequency of re-admission were not different, but the median overall survival (4.3 months vs. 3.4 months, respectively) was significantly different. By multivariate analysis, the presence of peritoneal metastasis was identified as the independent prognostic factor for incurable gastric cancer.

Conclusion: A prophylactic bypass procedure is not effective for improving the quality of life and prolonging the life expectancy of unresectable stage IV gastric cancer patients without obstruction.
KEYWORD
Unresectable gastric cancer, Stage IV gastric cancer, Gastrojejunostomy
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