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Gastrectomy in comprehensive treatment of advanced gastric cancer with synchronous liver metastasis: a prospectively comparative study
- Source :
- World Journal of Surgical Oncology
- Publication Year :
- 2015
-
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.
- 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
Subjects
Details
- ISSN :
- 14777819
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- World journal of surgical oncology
- Accession number :
- edsair.doi.dedup.....fe50844f924a73b0eb717203525069d5