1. Gastrectomy in comprehensive treatment of advanced gastric cancer with synchronous liver metastasis: a prospectively comparative study
- Author
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Fei Shan, Zhaode Bu, Lianhai Zhang, Hui Ren, Xiang-Long Zong, Ziyu Li, Shuangxi Li, Lei Tang, Biao Fan, Aiwen Wu, Xiaojiang Wu, and Jiafu Ji
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Advanced gastric cancer ,Paclitaxel ,medicine.medical_treatment ,Adenocarcinoma ,Metastasis ,Neoplasms, Multiple Primary ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Carcinoma ,Medicine ,Humans ,Prospective Studies ,Carcinoma, Small Cell ,Survival rate ,Liver metastasis ,Capecitabine ,Neoplasm Staging ,Chemotherapy ,business.industry ,Research ,digestive, oral, and skin physiology ,Liver Neoplasms ,Cancer ,Middle Aged ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Hepatic resection ,digestive system diseases ,Survival Rate ,Chemotherapy, Adjuvant ,Case-Control Studies ,Adjuvant gastrectomy ,Surgery ,Female ,Neoplasm Grading ,business ,Carcinoma, Signet Ring Cell ,Follow-Up Studies - 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. Electronic supplementary material The online version of this article (doi:10.1186/s12957-015-0627-1) contains supplementary material, which is available to authorized users.
- Published
- 2015