Curative Gastrectomy with Perioperative Chemotherapy Improves the Survival for Unresectable Gastric Cancer

Background/Aim: Although there are a few reports recommending gastrectomy for unresectable gastric cancer (UGC) to improve survival, the advantage of gastrectomy remains unclear. The objective of this study was to assess the meanings of the surgical intervention. Patients and Methods: Therapeutic outcomes were retrospectively evaluated in 127 patients with UGC. All patients had chemotherapy and 47 patients underwent gastrectomy. Patients were classified to three groups according to the treatment. Results: Multivariate analysis showed that gastrectomy was in independent favorable prognosis factor (p<0.001) as well as performance status 0/1, differentiated type, absence of distant organ metastasis, and second line chemotherapy for UGC. Among the patients with gastrectomy, R0 resection was an independent prognostic factor (p=0.011). R0 resection was mainly achieved when there was a single non-curable factor and no distant organ metastasis (p=0.007 and p=0.024, respectively). Conclusion: Gastrectomy has an advantage in improving the survival in selected cases among UGC. If chemotherapy enables to control the non-curable factors, gastrectomy should be considered.

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