Palliative total gastrectomy and esophagogastrectomy a reevaluation

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Abstract
In the interval from 1941–1981 when 1887 patients with gastric cancer were seen at The University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute, 151 curative and 45 palliative total gastrectomies or esophagogastrectomies were performed. Over the same interval, 21 patients with extent of primary and metastatic tumor roughly comparable to that seen in the palliative resection group were treated by exploration only or, infrequently, by attempted bypass. In individual patients subtle differences in extent of disease as well as differences in philosophy of the operating surgeon regarding the value of palliative resection undoubtedly contributed to the procedure selected. Survival after curative resection was greater than after palliative resection which in turn was greater than survival after exploration bypass (P ⩽.0006). Operative mortality fell significantly in CR patients in the interval 1970–1981 compared to 1941–1969 and was significantly lower than in the PR group in the interval 1970–1981 (P ⩽ 0.01). Five‐year survival increased significantly (P ⩽ 0.03) in the CR group when results in the two time intervals were compared but not in other groups.