Palliative surgical treatment of gastric carcinoma, duration of survival in 217 cases

• Published in: Public choice 1976-01, Vol.28 (1), p.5-12
• Main Author: Zwaveling, A
• Format: Article
• Language: English
• ISSN: 0004-0657

During the period 1958 to 1972 inclusive, 217 patients were subjected to a palliative operation because of carcinoma of the stomach. Subtotal gastric resection was performed in 33 and a total resection in 42 cases. The postoperative mortality in the resected group amounted to 8%. The average duration of survival with exclusion of the postoperative mortality amounted to 17 months with a median duration of 12 months. Five patients in this group (7%) survived for 5 years, and two patients are still alive without recurrence 9 and 6 years, respectively, after the operation. Among the 142 remaining patients, the postoperative mortality was 23%. The average survival with exclusion of the postoperative mortality was 5 months; the median duration of survival amounted to 4 months. The average duration of survival among the patients subjected to a gastro- or jejunostomy was shorter: 3 months, with a median of 2 months. Of the various palliative measures, resection is to be preferred. If it is not feasible, gastro-enterostomy and intubation may be considered. In a limited number of cases, the alimentary fistula may still be indicated, even though it is an unsatisfactory type of palliation. Hoerr's classification is satisfactory as a clinical subdivision. The dividing line between operations with curative and with palliative intent as a rule is put at B III. Of the patients treated palliatively, 92% had died after 2 years; 79% of those subjected to resection and 100% of those subjected to some other intervention.