Journal Article

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

Fan, Biao, Zong, Xianglong, Shan, Fei, Tang, Lei, Li, Ziyu, Bu, Zhaode, Zhang, Lianhai, Wu, Xiaojiang, Ji, Jiafu, Wu, Aiwen, Ren, Hui, Li, Shuangxi

2015

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd
• Subject: Adenocarcinoma - drug therapy / Adenocarcinoma - mortality / Adenocarcinoma - secondary / Adenocarcinoma - surgery / Adjuvant treatment / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Cancer / Capecitabine - administration & dosage / Carcinoma, Signet Ring Cell - drug therapy / Carcinoma, Signet Ring Cell - mortality / Carcinoma, Signet Ring Cell - secondary / Carcinoma, Signet Ring Cell - surgery / Carcinoma, Small Cell - drug therapy / Carcinoma, Small Cell - mortality / Carcinoma, Small Cell - secondary / Carcinoma, Small Cell - surgery / Care and treatment / Case-Control Studies / Chemotherapy, Adjuvant / Combined Modality Therapy / Comparative analysis / Development and progression / Drug therapy / Female / Follow-Up Studies / Gastrectomy / Health aspects / Humans / Liver cancer / Liver Neoplasms - drug therapy / Liver Neoplasms - mortality / Liver Neoplasms - secondary / Liver Neoplasms - surgery / Male / Medicine / Medicine & Public Health / Metastasis / Middle Aged / Neoplasm Grading / Neoplasm Staging / Neoplasms, Multiple Primary - drug therapy / Neoplasms, Multiple Primary - mortality / Neoplasms, Multiple Primary - pathology / Neoplasms, Multiple Primary - surgery / Oncology, Experimental / Paclitaxel - administration & dosage / Prognosis / Prospective Studies / Stomach cancer / Stomach Neoplasms - drug therapy / Stomach Neoplasms - mortality / Stomach Neoplasms - pathology / Stomach Neoplasms - surgery / Surgical Oncology / Survival Rate