PMID- 23493860
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130318
LR  - 20211021
IS  - 1948-9366 (Print)
IS  - 1948-9366 (Electronic)
VI  - 4
IP  - 12
DP  - 2012 Dec 27
TI  - Evaluation of salvage surgery for type 4 gastric cancer.
PG  - 301-5
LID - 10.4240/wjgs.v4.i12.301 [doi]
AB  - Patients with type 4 gastric cancer and peritoneal metastasis respond better to 
      chemotherapy than surgery. In particular, patients without gastric stenosis who 
      can consume a meal usually experience better quality of life (QOL). However, some 
      patients with unsuccessful chemotherapy are unable to consume a meal because of 
      gastric stenosis and obstruction. These patients ultimately require salvage 
      surgery to enable them to consume food normally. We evaluated the outcomes of 
      salvage total gastrectomy after chemotherapy in four patients with gastric 
      stenosis. We determined clinical outcomes of four patients who underwent total 
      gastrectomy as salvage surgery. Outcomes were time from chemotherapy to death and 
      QOL, which was assessed using the Support Team Assessment Schedule-Japanese 
      version (STAS-J). Three of the patients received combination chemotherapy 
      [tegafur, gimestat and otastat potassium (TS-1); cisplatin]. Two of these 
      patients underwent salvage chemotherapy after 12 and 4 mo of chemotherapy. 
      Following surgery, they could consume food adequately and their STAS-J scores 
      improved, so their treatments were continued. The third patient underwent salvage 
      surgery after 7 mo of chemotherapy. This patient was unable to consume food 
      adequately after surgery and developed surgical complications. His clinical 
      outcomes at 3 mo were very poor. The fourth patient received combination 
      chemotherapy (TS-1 and irinotecan hydrochloride) for 6 mo and then underwent 
      received salvage surgery. After surgery, he could consume food adequately and his 
      STAS-J score improved, so his treatment was continued. After the surgery, he 
      enjoyed his life for 16 mo. Of four patients who received salvage total 
      gastrectomy after unsuccessful chemotherapy, the QOL improved in three patients, 
      but not in the other patient. Salvage surgery improves QOL in most patients, but 
      some patients develop surgical complications that prevent improvements in QOL. If 
      salvage surgery is indicated, the surgeon and/or oncologist must provide the 
      patient with a clear explanation of the purpose of surgery, as well as the 
      possible risks and benefits to allow the patient to reach an informed decision on 
      whether to consent to the procedure.
FAU - Hashimoto, Toshio
AU  - Hashimoto T
AD  - Toshio Hashimoto, Department of Surgery, Yonezawa City Hospital, 6-36, Aioicho, 
      Yonezawa, Yamagata 992-8502, Japan.
FAU - Usuba, Osamu
AU  - Usuba O
FAU - Toyono, Mitsuru
AU  - Toyono M
FAU - Nasu, Ikuko
AU  - Nasu I
FAU - Takeda, Miwako
AU  - Takeda M
FAU - Suzuki, Miho
AU  - Suzuki M
FAU - Endou, Toshiko
AU  - Endou T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Gastrointest Surg
JT  - World journal of gastrointestinal surgery
JID - 101532473
PMC - PMC3596528
OTO - NOTNLM
OT  - Gastric stenosis
OT  - Palliative care
OT  - Quality of life
OT  - Salvage surgery
OT  - Support Team Assessment Schedule-Japanese version
OT  - Systemic chemotherapy
OT  - Type 4 gastric cancer
EDAT- 2013/03/16 06:00
MHDA- 2013/03/16 06:01
PMCR- 2012/12/27
CRDT- 2013/03/16 06:00
PHST- 2012/11/11 00:00 [received]
PHST- 2012/12/13 00:00 [revised]
PHST- 2013/12/23 00:00 [accepted]
PHST- 2013/03/16 06:00 [entrez]
PHST- 2013/03/16 06:00 [pubmed]
PHST- 2013/03/16 06:01 [medline]
PHST- 2012/12/27 00:00 [pmc-release]
AID - 10.4240/wjgs.v4.i12.301 [doi]
PST - ppublish
SO  - World J Gastrointest Surg. 2012 Dec 27;4(12):301-5. doi: 10.4240/wjgs.v4.i12.301.