Rahul Gadde1,2, Leonardo Tamariz2, Mena Hanna1, Eli Avisar1,3, Alan Livingstone1,3, Dido Franceschi1,3, Danny Yakoub1,3. 1. Division of Surgical Oncology at Department of Surgery, University of Miami-Miller School of Medicine, Miami, Florida. 2. Department of Internal Medicine, University of Miami-Miller School of Medicine, Miami, Florida. 3. Sylvester Comprehensive Cancer Center, University of Miami-Miller School of Medicine, Miami, Florida.
Abstract
BACKGROUND: Prognosis with current management strategies continues to be dismal in metastatic gastric cancer (MGC) patients. We aimed to evaluate the role of metastasectomy in improving survival. METHODS: A comprehensive search of MEDLINE, EMBASE, SCOPUS, and Cochrane central databases (1965 to present) was performed. All comparative studies measuring survival in MGC patients undergoing metastasectomy versus other therapies were included. Pooled risk ratios with corresponding 95% confidence intervals (CI) were calculated for survival at 1, 3, and 5 years. RESULTS: Sixteen studies with 1712 patients (378 patients in metastasectomy, 1334 patients in other therapies) were eligible for the final meta-analysis. Median age was 63 years. For patients undergoing metastasectomy, a significant survival advantage was observed at 1 year (RR 0.52, CI 0.43-0.62), 3 year (RR 0.75 CI 0.67-0.83), and 5 year (RR 0.82, CI 0.74-0.91); mean increased difference in survival conferred by metastasectomy averaged between 9.3 and 15.7 months; P < 0.001 for all results. Age, ECOG status, and STROBE score did not contribute to differences in survival. CONCLUSION: Metastasectomy is associated with increased survival at 1, 3, and 5 years in MGC patients. Large prospective randomized controlled trials are critically needed to evaluate the role of metastasectomy in MGC.
BACKGROUND: Prognosis with current management strategies continues to be dismal in metastatic gastric cancer (MGC) patients. We aimed to evaluate the role of metastasectomy in improving survival. METHODS: A comprehensive search of MEDLINE, EMBASE, SCOPUS, and Cochrane central databases (1965 to present) was performed. All comparative studies measuring survival in MGC patients undergoing metastasectomy versus other therapies were included. Pooled risk ratios with corresponding 95% confidence intervals (CI) were calculated for survival at 1, 3, and 5 years. RESULTS: Sixteen studies with 1712 patients (378 patients in metastasectomy, 1334 patients in other therapies) were eligible for the final meta-analysis. Median age was 63 years. For patients undergoing metastasectomy, a significant survival advantage was observed at 1 year (RR 0.52, CI 0.43-0.62), 3 year (RR 0.75 CI 0.67-0.83), and 5 year (RR 0.82, CI 0.74-0.91); mean increased difference in survival conferred by metastasectomy averaged between 9.3 and 15.7 months; P < 0.001 for all results. Age, ECOG status, and STROBE score did not contribute to differences in survival. CONCLUSION: Metastasectomy is associated with increased survival at 1, 3, and 5 years in MGC patients. Large prospective randomized controlled trials are critically needed to evaluate the role of metastasectomy in MGC.
Authors: Mario Musella; Giovanna Berardi; Alessio Bocchetti; Roberta Green; Valeria Cantoni; Nunzio Velotti; Katia Di Lauro; Domenico Manzolillo; Antonio Vitiello; Marco Milone; Giovanni Domenico De Palma Journal: Obes Surg Date: 2019-08 Impact factor: 4.129
Authors: Raquel C Montenegro; Peter G K Clark; Alison Howarth; Xiao Wan; Alessandro Ceroni; Paulina Siejka; Graciela A Nunez-Alonso; Octovia Monteiro; Catherine Rogers; Vicki Gamble; Rommel Burbano; Paul E Brennan; Cynthia Tallant; Daniel Ebner; Oleg Fedorov; Eric O'Neill; Stefan Knapp; Darren Dixon; Susanne Müller Journal: Oncotarget Date: 2016-07-12