Limits...
Gastrectomy in comprehensive treatment of advanced gastric cancer with synchronous liver metastasis: a prospectively comparative study.

Li Z, Fan B, Shan F, Tang L, Bu Z, Wu A, Zhang L, Wu X, Zong X, Li S, Ren H, Ji J - World J Surg Oncol (2015)

Bottom Line: Multivariate analysis demonstrated that response to chemotherapy was the only independent factor in predicting prognosis.No significant difference in the survival of patients underwent combined hepatic resection when compared with patients performed gastrectomy only.For gastric cancer with synchronous liver metastasis, adjuvant gastrectomy followed by chemotherapy might be beneficial for survival comparing with chemotherapy alone, especially in patients response to initial preoperative chemotherapy.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, 52 Fu-Cheng Road, Hai-Dian District, Beijing, 100142, China. liziyupku@163.com.

ABSTRACT

Background: Systemic chemotherapy is the key treatment for advanced gastric cancer. The benefit of adjuvant surgery following preoperative chemotherapy in gastric cancer with liver metastasis has not been well established.

Methods: Forty-nine gastric cancer patients diagnosed with synchronous liver metastasis initially treated with chemotherapy were categorized into the following two groups: surgery group: 25 patients who underwent gastrectomy and subsequently received postoperative chemotherapy and control group: 24 patients who received chemotherapy alone.

Results: The median overall survival of patients in the surgery group and control group was 20.5 and 9.1 months, respectively, (P = 0.006). The median progression-free survival in the surgery group was 10.9 months, with statistical significance when compared with 5.0 months in the control group (P = 0.001). Multivariate analysis demonstrated that response to chemotherapy was the only independent factor in predicting prognosis. The survival of patients who achieved partial response (PR) was prolonged if they received adjuvant surgery (P = 0.024). No significant difference in the survival of patients underwent combined hepatic resection when compared with patients performed gastrectomy only.

Conclusions: For gastric cancer with synchronous liver metastasis, adjuvant gastrectomy followed by chemotherapy might be beneficial for survival comparing with chemotherapy alone, especially in patients response to initial preoperative chemotherapy.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves for survival in AGC patients with liver metastasis. a, b Comparison of OS and PFS between the adjuvant surgery and chemotherapy group. c Comparison of OS among the various responses to chemotherapy (PR, SD, and PD). d Comparison of OS between patients who initially achieved PR after chemotherapy then underwent adjuvant surgery and patients who only treated with chemotherapy initially achieved PR
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4491213&req=5

Fig1: Kaplan-Meier curves for survival in AGC patients with liver metastasis. a, b Comparison of OS and PFS between the adjuvant surgery and chemotherapy group. c Comparison of OS among the various responses to chemotherapy (PR, SD, and PD). d Comparison of OS between patients who initially achieved PR after chemotherapy then underwent adjuvant surgery and patients who only treated with chemotherapy initially achieved PR

Mentions: Median lengths of follow-up in the surgery group and control group were 19.6 and 9.5 months, respectively. The median overall survival (OS) of patients in the surgery group was 20.5 months, which was statistically more prolonged than 9.1 months in the control group (Fig. 1a, P = 0.006). The 1- and 2-year survival rates were 72 and 32 % in the surgery group and 41 and 8 % in the control group, respectively. In addition, the median PFS in the surgery group was 13.0 months, with statistical significance when compared with 5.8 months in the control group (Fig. 1b, P = 0.005).Fig. 1


Gastrectomy in comprehensive treatment of advanced gastric cancer with synchronous liver metastasis: a prospectively comparative study.

Li Z, Fan B, Shan F, Tang L, Bu Z, Wu A, Zhang L, Wu X, Zong X, Li S, Ren H, Ji J - World J Surg Oncol (2015)

Kaplan-Meier curves for survival in AGC patients with liver metastasis. a, b Comparison of OS and PFS between the adjuvant surgery and chemotherapy group. c Comparison of OS among the various responses to chemotherapy (PR, SD, and PD). d Comparison of OS between patients who initially achieved PR after chemotherapy then underwent adjuvant surgery and patients who only treated with chemotherapy initially achieved PR
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491213&req=5

Fig1: Kaplan-Meier curves for survival in AGC patients with liver metastasis. a, b Comparison of OS and PFS between the adjuvant surgery and chemotherapy group. c Comparison of OS among the various responses to chemotherapy (PR, SD, and PD). d Comparison of OS between patients who initially achieved PR after chemotherapy then underwent adjuvant surgery and patients who only treated with chemotherapy initially achieved PR
Mentions: Median lengths of follow-up in the surgery group and control group were 19.6 and 9.5 months, respectively. The median overall survival (OS) of patients in the surgery group was 20.5 months, which was statistically more prolonged than 9.1 months in the control group (Fig. 1a, P = 0.006). The 1- and 2-year survival rates were 72 and 32 % in the surgery group and 41 and 8 % in the control group, respectively. In addition, the median PFS in the surgery group was 13.0 months, with statistical significance when compared with 5.8 months in the control group (Fig. 1b, P = 0.005).Fig. 1

Bottom Line: Multivariate analysis demonstrated that response to chemotherapy was the only independent factor in predicting prognosis.No significant difference in the survival of patients underwent combined hepatic resection when compared with patients performed gastrectomy only.For gastric cancer with synchronous liver metastasis, adjuvant gastrectomy followed by chemotherapy might be beneficial for survival comparing with chemotherapy alone, especially in patients response to initial preoperative chemotherapy.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, 52 Fu-Cheng Road, Hai-Dian District, Beijing, 100142, China. liziyupku@163.com.

ABSTRACT

Background: Systemic chemotherapy is the key treatment for advanced gastric cancer. The benefit of adjuvant surgery following preoperative chemotherapy in gastric cancer with liver metastasis has not been well established.

Methods: Forty-nine gastric cancer patients diagnosed with synchronous liver metastasis initially treated with chemotherapy were categorized into the following two groups: surgery group: 25 patients who underwent gastrectomy and subsequently received postoperative chemotherapy and control group: 24 patients who received chemotherapy alone.

Results: The median overall survival of patients in the surgery group and control group was 20.5 and 9.1 months, respectively, (P = 0.006). The median progression-free survival in the surgery group was 10.9 months, with statistical significance when compared with 5.0 months in the control group (P = 0.001). Multivariate analysis demonstrated that response to chemotherapy was the only independent factor in predicting prognosis. The survival of patients who achieved partial response (PR) was prolonged if they received adjuvant surgery (P = 0.024). No significant difference in the survival of patients underwent combined hepatic resection when compared with patients performed gastrectomy only.

Conclusions: For gastric cancer with synchronous liver metastasis, adjuvant gastrectomy followed by chemotherapy might be beneficial for survival comparing with chemotherapy alone, especially in patients response to initial preoperative chemotherapy.

No MeSH data available.


Related in: MedlinePlus