Purpose Currently, there is no clear evidence to support any specific treatment as a principal therapy for stage IV gastric cancer outlet obstruction (GCOO) patients. This study evaluated the outcomes of palliative gastrectomies and survival prognostic factors in patients with stage IV resectable GCOO. Materials and Methods We retrospectively reviewed the medical records of 48 stage IV GCOO patients who underwent palliative gastrectomies between June 2010 and December 2019. Palliative gastrectomies were performed only in patients with resectable disease. Early surgical outcomes and prognostic factors were analyzed using univariate and multivariate analyses. Results There were no specific risk factors for postoperative complications, except for being underweight. Severe postoperative complications developed in five patients, and most of the patients underwent interventional procedures and received broad-spectrum antibiotics for intra-abdominal abscesses. The multivariate survival analysis showed that palliative chemotherapy is a positive prognostic factor, while the specific type of hematogenous and lymphatic metastasis is a negative prognostic factor. Conclusions We recommend that the treatment method for stage IV GCOO should be selected according to each patient's physical condition and tumor characteristics. In addition, we suggest that palliative gastrectomies can be performed in stage IV resectable GCOO patients without unfavorable prognostic factors (types of hematogenous and lymphatic metastases).

中文翻译：

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IV期可切除胃癌出口梗阻患者姑息性胃切除术的手术结果和生存预后因素

目的 目前，没有明确的证据支持将任何特定治疗作为 IV 期胃癌出口梗阻 (GCOO) 患者的主要治疗。本研究评估了 IV 期可切除 GCOO 患者姑息性胃切除术的结果和生存预后因素。材料与方法 我们回顾性分析了 2010 年 6 月至 2019 年 12 月期间接受姑息性胃切除术的 48 例 IV 期 GCOO 患者的病历。姑息性胃切除术仅在可切除疾病的患者中进行。使用单变量和多变量分析分析早期手术结果和预后因素。结果除体重不足外，术后并发症无特定危险因素。5名患者出现严重的术后并发症，大部分患者接受了介入手术，并接受了广谱抗生素治疗腹腔内脓肿。多因素生存分析显示，姑息性化疗是一个积极的预后因素，而特定类型的血行和淋巴转移是一个消极的预后因素。结论 建议IV期GCOO的治疗方法应根据每位患者的身体状况和肿瘤特点来选择。此外，我们建议在没有不利预后因素（血行和淋巴转移类型）的 IV 期可切除 GCOO 患者中进行姑息性胃切除术。多因素生存分析显示，姑息性化疗是一个积极的预后因素，而特定类型的血行和淋巴转移是一个消极的预后因素。结论 建议IV期GCOO的治疗方法应根据每位患者的身体状况和肿瘤特点来选择。此外，我们建议在没有不利预后因素（血行和淋巴转移类型）的 IV 期可切除 GCOO 患者中进行姑息性胃切除术。多因素生存分析显示，姑息性化疗是一个积极的预后因素，而特定类型的血行和淋巴转移是一个消极的预后因素。结论 建议IV期GCOO的治疗方法应根据每位患者的身体状况和肿瘤特点来选择。此外，我们建议在没有不利预后因素（血行和淋巴转移类型）的 IV 期可切除 GCOO 患者中进行姑息性胃切除术。身体状况和肿瘤特征。此外，我们建议在没有不利预后因素（血行和淋巴转移类型）的 IV 期可切除 GCOO 患者中进行姑息性胃切除术。身体状况和肿瘤特征。此外，我们建议在没有不利预后因素（血行和淋巴转移类型）的 IV 期可切除 GCOO 患者中进行姑息性胃切除术。