Evre IV mide karsinomlu hastalarda palyatif gastrektominin değeri

Amaç: Batı ülkelerinde ve ülkemizde tanı sırasında evre IV mide karsinoması ile sıklıkla karşılaşılmaktadır.Evre IV karsinomalı hastalarda palyatif gastrektominin yeri tartışmalıdır. Bu çalışmada, evre IV mide karsinomalı hastalarda palyatif gastrektominin sağkalım yararı sağlayıp sağlamadığı araştırıldı.Yöntem: Evre IV mide karsinoması olan ve ölünceye dek izlenen 183 hasta çalışmaya alındı; veriler prospektif olarak toplandı. Evre IV tümör oluşturma nedenleri arasında çevre yapılara invazyon (81 hasta) ve periton metastazı(36 hasta) ilk iki sırada yer almaktaydı, 33 hastada birden fazla neden vardı. Palyatif gastrektomi yapılan 52 hastanın yarısında total, yarısında subtotal gastrektomi uygulandı. Gastrektomi geçiren ve geçirmeyen hasta grupları mortalite ve genel sağkalım süresi açısından karşılaştırıldı; ameliyata bağlı nedenlerden ölen 30 hasta sağkalım analizine alınmadı. Bulgular: Mortalite oranı, gastrektomi geçiren hastalarda %9.6, rezeksiyon yapılmayanlarda %19.1 idi (p=0.181); total gastrektomi yapılanlarda % 3.8, subtotal gastrektomi yapılanlarda %15.3 idi (p=0.350). Ortanca genel sağkalım süresi gastrektomi geçiren 47 hasta için 6.5 ay olup rezeksiyon yapılmayan 106 hastanınkinden (3.5 ay) anlamlı olarak daha iyi idi (p=0.0002); gastrektomi yapılması bağımsız prognostik öneme sahipti (p

Value of palliative gastrectomy in patients with stage IV gastric carcinoma

Objectives: The role of palliative gastrectomy in stage IV gastric carcinoma is controversial. In this study, the effect of palliative gastrectomy on the survival in patients with stage IV gastric carcinoma was investigated. Methods: One hundred eighty three stage IV gastric carcinoma patients who were followed-up until death were included in the study; data was collected prospectively. Patients with gastrectomy were compared to those without gastrectomy in regard to mortality and overall survival time; the patients who dead due to operative causes (30 patients) were not included in survival analysis.Results: Mortality ratio was 9.6% in patients with gastrectomy and 19.1% in patients without gastrectomy (p=0.181). Median survival time for 47 patients with gastrectomy (6.5 months) was significantly longer than 106 patients without resection (3.5 months) (p=0002); gastrectomy procedure had an independent prognostic significance (p

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