Multidisciplinary treatment for patients with stage IV gastric cancer: The role of conversion surgery following chemotherapy 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis

Seung Hoon Beom, Yoon Young Choi, Song Ee Baek, Shuang Xi Li, Joon Seok Lim, Taeil Son, Hyoung Il Kim, Jae Ho Cheong, Woo Jin Hyung, Seung Ho Choi, Minkyu Jung, Hyo Song Kim, Hei Cheul Jeung, Hyun Cheol Chung, Sun Young Rha, Sung Hoon Noh

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Abstract

Background: With advances in gastric cancer chemotherapy, conversion surgery has drawn attention as a new strategy to improve the outcome of stage IV disease. We investigated the efficacy of conversion surgery following chemotherapy for patients with stage IV gastric cancer. Methods: We retrospectively reviewed clinico-pathologic variables and oncologic outcomes for 101 patients with stage IV gastric cancer who were treated with systemic chemotherapy followed by gastrectomy with intension of curative resection from January 2005 to December 2012. Results: In terms of the best response from palliative chemotherapy, complete or partial response were observed in 65 patients (64.4%) in overall. Complete response of metastatic site were observed in 72 (71.3%) and 66 (65.3%) patients as best and pre-operative response, respectively. The overall complete macroscopic resection, rate was 56.4%. Eleven patients (10.9%) received combined metastasectomy. There was no postoperative surgery-related mortality for 1 month. The median overall survival time was 26.0 months. Multivariable analysis identified complete macroscopic resection, chemotherapy response (complete response/partial response) of metastatic sites, and change in CEA level as independent prognostic factors contributing to overall survival. Conclusions: Patients with stage IV gastric cancer who exhibit a good clinical response to chemotherapy might obtain greater survival benefit from gastrectomy following chemotherapy compared with patients who exhibit a poor response to chemotherapy. Prospective, randomized trials are required to determine the best strategy for combining initial chemotherapy with subsequent gastrectomy.

Original languageEnglish
Article number1116
JournalBMC cancer
Volume18
Issue number1
DOIs
Publication statusPublished - 2018 Nov 15

All Science Journal Classification (ASJC) codes

  • Genetics
  • Oncology
  • Cancer Research

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    Beom, S. H., Choi, Y. Y., Baek, S. E., Li, S. X., Lim, J. S., Son, T., Kim, H. I., Cheong, J. H., Hyung, W. J., Choi, S. H., Jung, M., Kim, H. S., Jeung, H. C., Chung, H. C., Rha, S. Y., & Noh, S. H. (2018). Multidisciplinary treatment for patients with stage IV gastric cancer: The role of conversion surgery following chemotherapy 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis. BMC cancer, 18(1), [1116]. https://doi.org/10.1186/s12885-018-4998-x