Survival benefit of gastrectomy – metastasectomy in patients with metastatic gastric cancer receiving chemotherapy
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ki Hwan Kim Keun-Wook Lee Sun Kyung Baek Hye Jung Chang Yu Jung Kim Do Joong Park Jee Hyun Kim Hyung-Ho Kim Jong Seok Lee
- چاپ و سال / کشور: 2011
Description
Background This study was performed to investigate the role of surgery in patients with gastric cancer and distant metastases who had received systemic chemotherapy. Methods Patients with newly diagnosed gastric cancer and synchronous distant metastases who had received chemotherapy (n = 274) were categorized into 3 groups according to the surgical treatment rendered: complete gross resection of both primary and metastatic sites (group A; n = 42); debulking gastrectomy (group B; n = 47); and chemotherapy without debulking (group C; n = 185). Results The median overall survival of all patients was 11.8 months. The median overall survival and 3-year survival rates were 28.0, 15.5, and 9.0 months and 42.8, 8.1, and 3.5% in groups A, B, and C, respectively. In group A, patients with peritoneal seeding, intra-abdominal distant lymph nodes, or ovarian or hepatic metastases underwent complete gross resection, and 12 (29%) were disease-free at the time of the last analysis (median follow-up duration, 29.1 months). On multivariate analysis, the adjusted hazard ratios for death were 0.27 (P\0.001) and 0.64 (P = 0.024) for groups A and B, respectively, as compared to group C. Conclusions Our study suggests survival benefits of debulking gastrectomy or gastrectomy plus metastasectomy in gastric cancer patients with distant metastases receiving systemic chemotherapy. Prolonged disease-free survival was observed after complete resection (gastrectomy plus metastasectomy) that may lead to cure in some patients. Well-designed prospective trials of the role of multidisciplinary approaches combining chemotherapy and surgery are needed to confirm the observations of our study.
Gastric Cancer (2011) 14:130–138 DOI 10.1007/s10120-011-0015-7 Received: 21 July 2010 / Accepted: 16 November 2010 / Published online: 4 March 2011
