Palliative surgery in metastatic gastric cancer: analysis (2007-2021).

Objective: Patients with metastatic gastric cancer (MGC) may require palliative surgery to manage complications such as obstruction or bleeding. While the role of stenting in MGC is clear, the role of palliative surgery in MGC shows conflicting results.

Methods: We retrospectively reviewed clinical data of patients with MGC treated at our institution between January 2007 and December 2021. The clinical outcomes of patients who underwent palliative surgery are analysed in this review.

Results: Gastrojejunostomy (GJ) and palliative gastrectomy were performed in 48 and 28 patients, respectively. The median overall survival in the GJ and palliative gastrectomy groups were 9.25 and 11.25 months, respectively (p=0.21). On subgroup analysis, we found that the patients who were diagnosed with MGC intraoperatively had better survival compared with preoperatively diagnosed patients even though it was statistically not significant. The complication rates following GJ and palliative gastrectomy were 6% and 7%, respectively.

Conclusion: Both palliative gastrectomy and GJ offer similar results to endoscopic stenting, as reported in the literature. Surgical palliative options continue to be relevant in selected cases due to lower rates of repeat interventions and reduced hospital visits, making them a one-time solution for patients, especially in resource-constrained settings.