Clinical significance of adjuvant surgery following chemotherapy for patients with initially unresectable stage IV gastric cancer

Shuhei Ito, Eiji Oki, Yuichiro Nakashima, Koji Ando, Yukiharu Hiyoshi, Kippei Ohgaki, Hiroshi Saeki, Masaru Morita, Yoshihisa Sakaguchi, Yoshihiko Maehara

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16 Citations (Scopus)

Abstract

Background: More effective treatment is necessary to improve the poor prognosis for patients with unresectable gastric cancer. We investigated the efficacy and feasibility of adjuvant surgery following chemotherapy.

Patients and Methods: Records of 70 patients with unresectable stage IV gastric cancer who underwent induction chemotherapy were reviewed retrospectively. Patients who developed an absence of non-curative clinical factors during chemotherapy underwent gastrectomy [adjuvant surgery (AS) group]; the others continued chemotherapy [non-AS group].

Results: Non-AS and AS groups contained 56 (80%) and 14 (20%) patients, respectively. In the AS group, 92.9% of patients had one noncurative clinical factor, while 48.2% of patients in the non-AS group had two or more non-curative clinical factors (p=0.0386). In the AS group, operative outcomes, including the postoperative complication rate (21.4%), were acceptable. The 3-year overall survival rate in the AS group was 65.6% versus 7.7% in the non-AS group (p<0.0001). In patients with one noncurative clinical factor of peritoneal dissemination, the median survival of the AS group was 29.5 months versus 11.4 months in the non-AS group (p=0.0230).

Conclusion: Adjuvant surgery for initially unresectable stage IV gastric cancer was safe and feasible, and may improve the prognosis for patients with one non-curative clinical factor, such as peritoneal dissemination.

Original languageEnglish
Pages (from-to)401-406
Number of pages6
JournalAnticancer research
Volume35
Issue number1
Publication statusPublished - Jan 1 2015

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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