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Multidisciplinary treatment for patients with stage IV gastric cancer: the role of conversion surgery following chemotherapy

 Seung-Hoon Beom  ;  Yoon Young Choi  ;  Song-Ee Baek  ;  Shuang-Xi Li  ;  Joon Seok Lim  ;  Taeil Son  ;  Hyoung-Il Kim  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Seung Ho Choi  ;  Minkyu Jung  ;  Hyo Song Kim  ;  Hei-Cheul Jeung  ;  Hyun Cheol Chung  ;  Sun Young Rha  ;  Sung Hoon Noh 
 BMC Cancer, Vol.18(1) : 1116, 2018 
Journal Title
 BMC Cancer 
Issue Date
Chemotherapy ; Conversion surgery ; Gastrectomy ; Gastric cancer ; Metastasis
BACKGROUND: With advances in gastric cancer chemotherapy, conversion surgery has drawn attention as a new strategy to improve the outcome of stage IV disease. We investigated the efficacy of conversion surgery following chemotherapy for patients with stage IV gastric cancer. METHODS: We retrospectively reviewed clinico-pathologic variables and oncologic outcomes for 101 patients with stage IV gastric cancer who were treated with systemic chemotherapy followed by gastrectomy with intension of curative resection from January 2005 to December 2012. RESULTS: In terms of the best response from palliative chemotherapy, complete or partial response were observed in 65 patients (64.4%) in overall. Complete response of metastatic site were observed in 72 (71.3%) and 66 (65.3%) patients as best and pre-operative response, respectively. The overall complete macroscopic resection, rate was 56.4%. Eleven patients (10.9%) received combined metastasectomy. There was no postoperative surgery-related mortality for 1 month. The median overall survival time was 26.0 months. Multivariable analysis identified complete macroscopic resection, chemotherapy response (complete response/partial response) of metastatic sites, and change in CEA level as independent prognostic factors contributing to overall survival. CONCLUSIONS: Patients with stage IV gastric cancer who exhibit a good clinical response to chemotherapy might obtain greater survival benefit from gastrectomy following chemotherapy compared with patients who exhibit a poor response to chemotherapy. Prospective, randomized trials are required to determine the best strategy for combining initial chemotherapy with subsequent gastrectomy.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
백송이(Baek, Song Ee) ORCID logo https://orcid.org/0000-0001-8146-2570
범승훈(Beom, Seung Hoon) ORCID logo https://orcid.org/0000-0001-7036-3753
손태일(Son, Tae Il) ORCID logo https://orcid.org/0000-0002-0327-5224
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
정재호(Cheong, Jae Ho) ORCID logo https://orcid.org/0000-0002-1703-1781
정희철(Jeung, Hei Cheul) ORCID logo https://orcid.org/0000-0003-0952-3679
최승호(Choi, Seung Ho) ORCID logo https://orcid.org/0000-0002-9872-3594
최윤영(Choi, Yoon Young) ORCID logo https://orcid.org/0000-0002-2179-7851
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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