Purpose: The significance of aggressive chemotherapy for stage IV gastric carcinoma was retrospectively examined. Methods: This study analyzed 94 stage IV gastric cancer patients who underwent surgery with or without subsequent chemotherapeutic treatment. There were 29 potentially curative patients classified as Curability B and 65 noncurative patients classified as Curability C. These patients were divided into three groups chronologically according to the primary type of drugs administered as the 1st (1989-1998), the 2nd (1999-2002), and the 3rd term (2003-2005). Results: There was no significant difference in the survival time among the three groups (n = 94). The survival time of the patients classified as Curability C (n = 65) in the 3rd-term group (n = 17) was longer than that of the other two groups (P < 0.05). Similarly, the survival time in patients who were given new drugs and regimens (n = 22) was longer than that in those who were not (n = 43) in Curability C (P < 0.05). A multivariate analysis proved that the administrations of new drugs and regimens were independent factors for the prolongation of survival times for patients undergoing noncurative surgery (P < 0.01). Conclusions: These findings suggested that the administration of new anticancer drugs might bring about a favorable outcome for stage IV gastric cancer patients, especially in those with evidence of a residual tumor.
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