The aim of this study was to evaluate the survival benefit of palliative
gastrectomy for
gastric cancer patients with peritoneal seeding proven intraoperatively and to identify positive predictive factors for improving survival.The value of palliative resection for
gastric cancer patients with peritoneal
metastasis is controversial.From 2006 to 2013, 267
gastric cancer patients with intraoperatively identified peritoneal dissemination were retrospectively analyzed. Patients were divided into resection group and nonresection group according to whether a palliative
gastrectomy was performed. Clinicopathologic variables and survival were compared. Subgroup analyses stratified by clinicopathologic factors and multivariable analysis for overall survival were also performed.There were 114 patients in the resection group and 153 in nonresection group. The morbidities in the resection and nonresection groups were 14.91% and 5.88%, respectively (P = 0.014). There, however, was no difference in mortality between the 2 groups. The median survival time of patients in the resection group was longer than in nonresection group (14.00 versus 8.57 months, P = 0.000). The median survivals among the patients with different classifications of peritoneal
metastasis were statistically significant (P = 0.000). Patients undergoing resection followed by
chemotherapy had a significantly longer median survival, compared with that of patients who had
chemotherapy alone, those who had resection alone, or those who had not received
chemotherapy or resection (P = 0.000). Results of subgroup analyses showed that except for P3 patients and patients with multisite distant
metastases, overall survival was significantly better in patients with palliative
gastrectomy, compared with the nonresection group. In multivariate analysis, P3 disease (P = 0.000), absence of resection (P = 0.000), and lack of
chemotherapy (P = 0.000) were identified as independently associated with poor survival.Palliative
gastrectomy might be beneficial to the survival of
gastric cancer patients with intraoperatively proven P1/P2 alone, rather than P3. Postoperative palliative
chemotherapy could improve survival regardless of operation and should be recommended.