Sa-Hong Min1,2, Yongjoon Won1, Kanghaeng Lee1, Sang Il Youn1, Guowei Kim1,3, Young Suk Park1, Sang-Hoon Ahn1,4, Do Joong Park1,4, Hyung-Ho Kim5,6. 1. Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea. 2. Chungnam National University Sejong Hospital, Daejeon, South Korea. 3. University Surgical Cluster, National University Health System, Singapore, Singapore. 4. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea. hhkim@snubh.org. 6. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. hhkim@snubh.org.
Abstract
BACKGROUND: The standard recommended treatment of stage IV gastric cancer is palliative chemotherapy. The aim of this study is to evaluate the role of radical gastrectomy with metastasectomy in these patients, as well as to explore the feasibility and safety of a laparoscopic approach. METHODS: 117 consecutive patients with pathologically proven Stage IV gastric cancer who underwent radical gastrectomy with metastasectomy were enrolled in this study. We evaluated short-term and long-term outcomes, comparing laparoscopic surgery with open surgery by propensity score matching. RESULTS: The 5-year overall survival rate (OSR) was 23.2% and the median survival time (MST) was 19.8 months. After propensity scoring matching, the 5-year OSR and MST of laparoscopy group was 23.4%, 17.9 months and in the open group, it was 25.0%, 22.8 months (p = 0.882). The complication rate was 5.6% in the laparoscopy group and 23.4% in the open group (p = 0.069). In multivariate analysis, adjuvant chemotherapy, chemotherapy cycle, and postoperative complication were independent prognostic factors of overall survival. CONCLUSIONS: Radical gastrectomy with metastasectomy could have a potential role in stage IV gastric cancer. Laparoscopic gastrectomy with metastasectomy in selected stage IV gastric cancer patients is safe and feasible.
BACKGROUND: The standard recommended treatment of stage IV gastric cancer is palliative chemotherapy. The aim of this study is to evaluate the role of radical gastrectomy with metastasectomy in these patients, as well as to explore the feasibility and safety of a laparoscopic approach. METHODS: 117 consecutive patients with pathologically proven Stage IV gastric cancer who underwent radical gastrectomy with metastasectomy were enrolled in this study. We evaluated short-term and long-term outcomes, comparing laparoscopic surgery with open surgery by propensity score matching. RESULTS: The 5-year overall survival rate (OSR) was 23.2% and the median survival time (MST) was 19.8 months. After propensity scoring matching, the 5-year OSR and MST of laparoscopy group was 23.4%, 17.9 months and in the open group, it was 25.0%, 22.8 months (p = 0.882). The complication rate was 5.6% in the laparoscopy group and 23.4% in the open group (p = 0.069). In multivariate analysis, adjuvant chemotherapy, chemotherapy cycle, and postoperative complication were independent prognostic factors of overall survival. CONCLUSIONS: Radical gastrectomy with metastasectomy could have a potential role in stage IV gastric cancer. Laparoscopic gastrectomy with metastasectomy in selected stage IV gastric cancer patients is safe and feasible.
Authors: Yingjun Quan; Ao Huang; Min Ye; Ming Xu; Biao Zhuang; Peng Zhang; Bo Yu; Zhijun Min Journal: Gastric Cancer Date: 2015-07-28 Impact factor: 7.370
Authors: Ye Rim Chang; Dong Seok Han; Seong-Ho Kong; Hyuk-Joon Lee; Se Hyung Kim; Woo Ho Kim; Han-Kwang Yang Journal: Ann Surg Oncol Date: 2011-11-02 Impact factor: 5.344
Authors: Johannes Zacherl; Maximilian Zacherl; Christian Scheuba; Rudolf Steininger; Etienne Wenzl; Ferdinand Mühlbacher; Raimund Jakesz; Friedrich Längle Journal: J Gastrointest Surg Date: 2002 Sep-Oct Impact factor: 3.452