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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 patients who underwent adjuvant surgery. a Comparison of OS between patients who underwent gastrectomy and patients treated with combined gastric and hepatic resection. b Comparison of OS between patients who initially achieved PR after chemotherapy then underwent gastrectomy and patients who initially achieved PR after chemotherapy then treated with combined gastric and hepatic resection
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Fig2: Kaplan-Meier curves for survival in patients who underwent adjuvant surgery. a Comparison of OS between patients who underwent gastrectomy and patients treated with combined gastric and hepatic resection. b Comparison of OS between patients who initially achieved PR after chemotherapy then underwent gastrectomy and patients who initially achieved PR after chemotherapy then treated with combined gastric and hepatic resection

Mentions: To illustrate the efficacy of the hepatic resection in AGC with liver metastasis, we compared the survival of patients in the surgery group who underwent combined hepatic resection or not. The median OS was 16.3 months in patients with combined hepatic resection, with no statistical significance when compared with 30.0 months in patients without hepatic resection (Fig. 2a, P = 0.235). Importantly, among the patients who have achieved PR after preoperative chemotherapy, the median OS in patients who underwent combined gastric and hepatic resection was 23.3 months, with no statistical significance when compared with 30.0 months in patients treated with gastrectomy (Fig. 2b, P = 0.338).Fig. 2


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 patients who underwent adjuvant surgery. a Comparison of OS between patients who underwent gastrectomy and patients treated with combined gastric and hepatic resection. b Comparison of OS between patients who initially achieved PR after chemotherapy then underwent gastrectomy and patients who initially achieved PR after chemotherapy then treated with combined gastric and hepatic resection
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Kaplan-Meier curves for survival in patients who underwent adjuvant surgery. a Comparison of OS between patients who underwent gastrectomy and patients treated with combined gastric and hepatic resection. b Comparison of OS between patients who initially achieved PR after chemotherapy then underwent gastrectomy and patients who initially achieved PR after chemotherapy then treated with combined gastric and hepatic resection
Mentions: To illustrate the efficacy of the hepatic resection in AGC with liver metastasis, we compared the survival of patients in the surgery group who underwent combined hepatic resection or not. The median OS was 16.3 months in patients with combined hepatic resection, with no statistical significance when compared with 30.0 months in patients without hepatic resection (Fig. 2a, P = 0.235). Importantly, among the patients who have achieved PR after preoperative chemotherapy, the median OS in patients who underwent combined gastric and hepatic resection was 23.3 months, with no statistical significance when compared with 30.0 months in patients treated with gastrectomy (Fig. 2b, P = 0.338).Fig. 2

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