Wanren Peng1, Tai Ma1, Hui Xu1,2, Zhijun Wu1,3, Changhao Wu4, Guoping Sun1,2. 1. Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. 2. Anhui Institute for Cancer Prevention and Control, Hefei 230022, China. 3. Maanshan People' Hospital, Maanshan 243000, China. 4. Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK.
Abstract
BACKGROUND: This study aimed to investigate the effect of palliative gastrectomy on survival in stage IV gastric cancer. METHODS: Patients diagnosed with stage IV gastric cancer between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Survival curves were estimated by the Kaplan-Meier method before and after propensity score matching (PSM). Univariate and multivariate Cox analyses were performed to evaluate risk factors for survival in patients who underwent palliative gastrectomy. RESULTS: We examined 6,529 patients with stage IV gastric cancer, of which 625 underwent palliative gastrectomy. Using a 1:2 PSM, the 625 patients were matched with 1,250 patients from the no gastrectomy group. The overall survival was higher in the gastrectomy group before [hazard ratio (HR) =0.57, 95% confidence interval (CI): 0.53-0.62, P<0.0001] and after PSM (HR =0.51, 95% CI: 0.46-0.57, P<0.0001). Multivariate Cox analysis confirmed the survival benefits of palliative gastrectomy and chemotherapy. Older age, over-lapping lesions, non-adenocarcinomas, higher tumor grade, and lung metastasis significantly increased the risk of mortality. In the gastrectomy group, patients aged ≥80 years, diagnosed with grades 3/4 non-adenocarcinomas, or with lung metastasis showed poorer prognosis. However, chemotherapy could improve the survival of these patients. CONCLUSIONS: Palliative gastrectomy provides survival benefits to stage IV gastric cancer patients. However, age, tumor grade, tumor histology, and lung metastasis status should be considered while making a decision regarding gastrectomy. Chemotherapy should also be recommended for these patients. 2020 Journal of Gastrointestinal Oncology. All rights reserved.
BACKGROUND: This study aimed to investigate the effect of palliative gastrectomy on survival in stage IV gastric cancer. METHODS: Patients diagnosed with stage IV gastric cancer between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Survival curves were estimated by the Kaplan-Meier method before and after propensity score matching (PSM). Univariate and multivariate Cox analyses were performed to evaluate risk factors for survival in patients who underwent palliative gastrectomy. RESULTS: We examined 6,529 patients with stage IV gastric cancer, of which 625 underwent palliative gastrectomy. Using a 1:2 PSM, the 625 patients were matched with 1,250 patients from the no gastrectomy group. The overall survival was higher in the gastrectomy group before [hazard ratio (HR) =0.57, 95% confidence interval (CI): 0.53-0.62, P<0.0001] and after PSM (HR =0.51, 95% CI: 0.46-0.57, P<0.0001). Multivariate Cox analysis confirmed the survival benefits of palliative gastrectomy and chemotherapy. Older age, over-lapping lesions, non-adenocarcinomas, higher tumor grade, and lung metastasis significantly increased the risk of mortality. In the gastrectomy group, patients aged ≥80 years, diagnosed with grades 3/4 non-adenocarcinomas, or with lung metastasis showed poorer prognosis. However, chemotherapy could improve the survival of these patients. CONCLUSIONS: Palliative gastrectomy provides survival benefits to stage IV gastric cancer patients. However, age, tumor grade, tumor histology, and lung metastasis status should be considered while making a decision regarding gastrectomy. Chemotherapy should also be recommended for these patients. 2020 Journal of Gastrointestinal Oncology. All rights reserved.
Authors: Shahid Ahmed; Anne Leis; Anthony Fields; Selliah Chandra-Kanthan; Kamal Haider; Riaz Alvi; Bruce Reeder; Punam Pahwa Journal: Cancer Date: 2013-11-12 Impact factor: 6.860
Authors: Neda Amini; Gaya Spolverato; Yuhree Kim; Malcolm H Squires; George A Poultsides; Ryan Fields; Carl Schmidt; Sharon M Weber; Konstantinos Votanopoulos; Shishir K Maithel; Timothy M Pawlik Journal: J Surg Oncol Date: 2014-10-10 Impact factor: 3.454