Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy
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...
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2011-06, Vol.14 (2), p.130-138 |
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| container_title | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association |
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| creator | Kim, Ki Hwan Lee, Keun-Wook Baek, Sun Kyung Chang, Hye Jung Kim, Yu Jung Park, Do Joong Kim, Jee Hyun Kim, Hyung-Ho Lee, Jong Seok |
| 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
|
| doi_str_mv | 10.1007/s10120-011-0015-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_871387351</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>871387351</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-931fd774f78cfb03e25e30d3fd89297b978074a8ff84b35464ed7b04fe00fd203</originalsourceid><addsrcrecordid>eNp1kcFO3DAQhq2qqEu3fQAuyOqlp8A4jtfJESFokZB6oD1bjjPeNdoki-0s2rfhFXiFfbI6ygISEqcZzXz_b2t-Qk4YnDEAeR4YsBwyYCwDYCKTn8gxK_gi4xzE55c-r9iMfA3hfmQqtvhCZjnjkpdCHJPhbvBbt9VrWmOH1kXaW7rUIXo0sW93-6f98_6pxZhGOkwz6jq60dFhFwN9dHFFD_vozKRN1ejOoKfJBt3WdUtqVtj2cYVeb3bfyJHV64DfD3VO_l1f_b38nd3--XVzeXGbmYLLmFWc2UbKwsrS2Bo45gI5NNw2ZZVXsq5kCbLQpbVlUXNRLApsZA2FRQDb5MDn5Ofku_H9w4AhqtYFg-u17rAfgiol46XkgiXyxzvyvh98lz6XIBBiIfhoxybI-D4Ej1ZtvGu13ykGakxETYmolIgar61k0pwejIe6xeZV8RJBAvIJCGnVLdG_vfyx63_9JZqH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>870556530</pqid></control><display><type>article</type><title>Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Kim, Ki Hwan ; Lee, Keun-Wook ; Baek, Sun Kyung ; Chang, Hye Jung ; Kim, Yu Jung ; Park, Do Joong ; Kim, Jee Hyun ; Kim, Hyung-Ho ; Lee, Jong Seok</creator><creatorcontrib>Kim, Ki Hwan ; Lee, Keun-Wook ; Baek, Sun Kyung ; Chang, Hye Jung ; Kim, Yu Jung ; Park, Do Joong ; Kim, Jee Hyun ; Kim, Hyung-Ho ; Lee, Jong Seok</creatorcontrib><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.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-011-0015-7</identifier><identifier>PMID: 21373855</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Adenocarcinoma - drug therapy ; Adenocarcinoma - mortality ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents - therapeutic use ; Cancer Research ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Gastrectomy ; Gastric cancer ; Gastroenterology ; Humans ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Metastasis - therapy ; Neoplasm Staging ; Oncology ; Original Article ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - mortality ; Stomach Neoplasms - surgery ; Surgical Oncology ; Young Adult</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2011-06, Vol.14 (2), p.130-138</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-931fd774f78cfb03e25e30d3fd89297b978074a8ff84b35464ed7b04fe00fd203</citedby><cites>FETCH-LOGICAL-c437t-931fd774f78cfb03e25e30d3fd89297b978074a8ff84b35464ed7b04fe00fd203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-011-0015-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-011-0015-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21373855$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Ki Hwan</creatorcontrib><creatorcontrib>Lee, Keun-Wook</creatorcontrib><creatorcontrib>Baek, Sun Kyung</creatorcontrib><creatorcontrib>Chang, Hye Jung</creatorcontrib><creatorcontrib>Kim, Yu Jung</creatorcontrib><creatorcontrib>Park, Do Joong</creatorcontrib><creatorcontrib>Kim, Jee Hyun</creatorcontrib><creatorcontrib>Kim, Hyung-Ho</creatorcontrib><creatorcontrib>Lee, Jong Seok</creatorcontrib><title>Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><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.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Cancer Research</subject><subject>Combined Modality Therapy</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Metastasis - therapy</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgical Oncology</subject><subject>Young Adult</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kcFO3DAQhq2qqEu3fQAuyOqlp8A4jtfJESFokZB6oD1bjjPeNdoki-0s2rfhFXiFfbI6ygISEqcZzXz_b2t-Qk4YnDEAeR4YsBwyYCwDYCKTn8gxK_gi4xzE55c-r9iMfA3hfmQqtvhCZjnjkpdCHJPhbvBbt9VrWmOH1kXaW7rUIXo0sW93-6f98_6pxZhGOkwz6jq60dFhFwN9dHFFD_vozKRN1ejOoKfJBt3WdUtqVtj2cYVeb3bfyJHV64DfD3VO_l1f_b38nd3--XVzeXGbmYLLmFWc2UbKwsrS2Bo45gI5NNw2ZZVXsq5kCbLQpbVlUXNRLApsZA2FRQDb5MDn5Ofku_H9w4AhqtYFg-u17rAfgiol46XkgiXyxzvyvh98lz6XIBBiIfhoxybI-D4Ej1ZtvGu13ykGakxETYmolIgar61k0pwejIe6xeZV8RJBAvIJCGnVLdG_vfyx63_9JZqH</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Kim, Ki Hwan</creator><creator>Lee, Keun-Wook</creator><creator>Baek, Sun Kyung</creator><creator>Chang, Hye Jung</creator><creator>Kim, Yu Jung</creator><creator>Park, Do Joong</creator><creator>Kim, Jee Hyun</creator><creator>Kim, Hyung-Ho</creator><creator>Lee, Jong Seok</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy</title><author>Kim, Ki Hwan ; Lee, Keun-Wook ; Baek, Sun Kyung ; Chang, Hye Jung ; Kim, Yu Jung ; Park, Do Joong ; Kim, Jee Hyun ; Kim, Hyung-Ho ; Lee, Jong Seok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-931fd774f78cfb03e25e30d3fd89297b978074a8ff84b35464ed7b04fe00fd203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Cancer Research</topic><topic>Combined Modality Therapy</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Metastasis - therapy</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgical Oncology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Ki Hwan</creatorcontrib><creatorcontrib>Lee, Keun-Wook</creatorcontrib><creatorcontrib>Baek, Sun Kyung</creatorcontrib><creatorcontrib>Chang, Hye Jung</creatorcontrib><creatorcontrib>Kim, Yu Jung</creatorcontrib><creatorcontrib>Park, Do Joong</creatorcontrib><creatorcontrib>Kim, Jee Hyun</creatorcontrib><creatorcontrib>Kim, Hyung-Ho</creatorcontrib><creatorcontrib>Lee, Jong Seok</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Ki Hwan</au><au>Lee, Keun-Wook</au><au>Baek, Sun Kyung</au><au>Chang, Hye Jung</au><au>Kim, Yu Jung</au><au>Park, Do Joong</au><au>Kim, Jee Hyun</au><au>Kim, Hyung-Ho</au><au>Lee, Jong Seok</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>14</volume><issue>2</issue><spage>130</spage><epage>138</epage><pages>130-138</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>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.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>21373855</pmid><doi>10.1007/s10120-011-0015-7</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2011-06, Vol.14 (2), p.130-138 |
| issn | 1436-3291 1436-3305 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Abdominal Surgery Adenocarcinoma - drug therapy Adenocarcinoma - mortality Adenocarcinoma - surgery Adult Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Cancer Research Combined Modality Therapy Disease-Free Survival Female Gastrectomy Gastric cancer Gastroenterology Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Neoplasm Metastasis - therapy Neoplasm Staging Oncology Original Article Proportional Hazards Models Retrospective Studies Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Stomach Neoplasms - surgery Surgical Oncology Young Adult |
| title | Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy |
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