Journal of Gastric Cancer

  • 제13권4호
  • /
  • Pages.226-231
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  • 2013
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Role of Metastasectomy on Overall Survival of Patients with Metastatic Gastric Cancer

  • Yang, Seung Wook (Department of Surgery, Hanyang University Seoul Hospital) ;
  • Kim, Min Gyu (Department of Surgery, Hanyang University Seoul Hospital) ;
  • Lee, Ju Hee (Department of Surgery, Hanyang University Seoul Hospital) ;
  • Kwon, Sung Joon (Department of Surgery, Hanyang University Seoul Hospital)
  • 투고 : 2013.08.28
  • 심사 : 2013.10.21
  • 발행 : 2013.12.30
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초록

Purpose: The role of metastasectomy has been debatable and unclear in the treatment for patients with metastatic gastric cancer. Therefore, this study was designed to evaluate the role of metastasectomy on the overall survival of these patients. Materials and Methods: In 2,406 patients who underwent gastrectomy for gastric cancer between 1998 and 2010, 188 (7.8%) patients had their first surgery for metastatic gastric cancer. To minimize the bias of systemic chemotherapy, 99 patients who received postoperative chemotherapy (fewer than 2 cycles) were excluded. The primary gastrectomy or metastasectomy had not been enforced in the following cases. Patients with far advanced peritoneal dissemination, multiple liver and lung metastasis (more than 2), and a poor general condition (Eastern Cooperative Oncology Group>2) were excluded. Based on the metastasectomy, the patients were classified into two groups, gastrectomy with metastasectomy and gastrectomy only group. Results: There was no significant difference between both groups in clinicopathological characteristics except for the mean age (P=0.047). The univariate analysis for overall survival show statistical significances in metastasectomy (P=0.026), distal gastrectomy (P=0.047), and combined resection of another organ (P=0.047) group. With a multivariate analysis, metastasectomy was a significant factor in patient survival after surgery (odds ratio 1.679; P=0.034). Conclusions: Based on our results, we assume that a detailed strategy for surgery is needed to improve the overall survival of patients with metastatic gastric cancer. Therefore, we suggest that a metastasectomy can help prolong overall survival in some patients with metastatic gastric cancer.

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참고문헌

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011;61:69-90. https://doi.org/10.3322/caac.20107
  2. Yang L, Parkin DM, Ferlay J, Li L, Chen Y. Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev 2005;14:243-250.
  3. Hartgrink HH, Putter H, Klein Kranenbarg E, Bonenkamp JJ, van de Velde CJ; Dutch Gastric Cancer Group. Value of palliative resection in gastric cancer. Br J Surg 2002;89:1438-1443. https://doi.org/10.1046/j.1365-2168.2002.02220.x
  4. Swan R, Miner TJ. Current role of surgical therapy in gastric cancer. World J Gastroenterol 2006;12:372-379. https://doi.org/10.3748/wjg.v12.i3.372
  5. Maekawa S, Saku M, Maehara Y, Sadanaga N, Ikejiri K, Anai H, et al. Surgical treatment for advanced gastric cancer. Hepatogastroenterology 1996;43:178-186.
  6. Kikuchi S, Tsukamoto H, Mieno H, Sato K, Kobayashi N, Shimao H, et al. Results of resection of gastric cancer with distant metastases. Hepatogastroenterology 1998;45:592-596.
  7. Inada T, Ogata Y, Kubota T, Ishihara M, Tomikawa M, Ando J, et al. D2-lymphadenectomy improves the survival of patients with peritoneal cytology-positive gastric cancer. Anticancer Res 2002;22:291-294.
  8. Medina-Franco H, Contreras-Saldivar A, Ramos-De La Medina A, Palacios-Sanchez P, Cortes-Gonzalez R, Ugarte JA. Surgery for stage IV gastric cancer. Am J Surg 2004;187:543-546 https://doi.org/10.1016/j.amjsurg.2003.12.045
  9. Lin SZ, Tong HF, You T, Yu YJ, Wu WJ, Chen C, et al. Palliative gastrectomy and chemotherapy for stage IV gastric cancer. J Cancer Res Clin Oncol 2008;134:187-192.
  10. Kobayashi Y, Fukui T, Ito S, Shitara K, Ito S, Hatooka S, et al. Pulmonary metastasectomy for gastric cancer: a 13-year single-institution experience. Surg Today 2013;43:1382-1389. https://doi.org/10.1007/s00595-012-0432-1
  11. Doglietto GB, Pacelli F, Caprino P, Alfieri S, Carriero C, Malerba M, et al. Palliative surgery for far-advanced gastric cancer: a retrospective study on 305 consecutive patients. Am Surg 1999;65:352-355.
  12. Sarela AI, Yelluri S; Leeds Upper Gastrointestinal Cancer Multidisciplinary Team. Gastric adenocarcinoma with distant metastasis: is gastrectomy necessary? Arch Surg 2007;142:143-149 https://doi.org/10.1001/archsurg.142.2.143
  13. Chow LW, Lim BH, Leung SY, Branicki FJ, Gertsch P. Gastric carcinoma with synchronous liver metastases: palliative gastrectomy or not? Aust N Z J Surg 1995;65:719-723. https://doi.org/10.1111/j.1445-2197.1995.tb00544.x
  14. Ouchi K, Sugawara T, Ono H, Fujiya T, Kamiyama Y, Kakugawa Y, et al. Therapeutic significance of palliative operations for gastric cancer for survival and quality of life. J Surg Oncol 1998;69:41-44. https://doi.org/10.1002/(SICI)1096-9098(199809)69:1<41::AID-JSO8>3.0.CO;2-K
  15. Kunisaki C, Shimada H, Akiyama H, Nomura M, Matsuda G, Ono H. Survival benefit of palliative gastrectomy in advanced incurable gastric cancer. Anticancer Res 2003;23:1853-1858.
  16. Ajani JA, Barthel JS, Bekaii-Saab T, Bentrem DJ, D'Amico TA, Das P, et al; NCCN Gastric Cancer Panel. Gastric cancer. J Natl Compr Canc Netw 2010;8:378-409.
  17. McCarter MD, Fong Y. Role for surgical cytoreduction in multimodality treatments for cancer. Ann Surg Oncol 2001;8:38-43 https://doi.org/10.1007/s10434-001-0038-0
  18. Pollock RE, Roth JA. Cancer-induced immunosuppression: implications for therapy? Semin Surg Oncol 1989;5:414-419. https://doi.org/10.1002/ssu.2980050607
  19. Koga S, Kawaguchi H, Kishimoto H, Tanaka K, Miyano Y, Kimura O, et al. Therapeutic significance of noncurative gastrectomy for gastric cancer with liver metastasis. Am J Surg 1980;140:356-359. https://doi.org/10.1016/0002-9610(80)90167-1

피인용 문헌

  1. Hepatic metastases from gastric cancer: A surgical perspective vol.21, pp.41, 2013, https://doi.org/10.3748/wjg.v21.i41.11489
  2. Metastatic gastric cancer (MGC) patients: Can we improve survival by metastasectomy? A systematic review and meta‐analysis vol.112, pp.1, 2013, https://doi.org/10.1002/jso.23945
  3. The role of surgery in the therapeutic approach of gastric cancer liver metastases vol.35, pp.5, 2013, https://doi.org/10.1007/s12664-016-0683-7
  4. Addition of peritonectomy to gastrectomy can predict good prognosis of gastric adenocarcinoma patients with intraoperatively proven single P1/P2 carcinomatosis vol.39, pp.6, 2013, https://doi.org/10.1177/1010428317697567
  5. The survival benefit of palliative gastrectomy and/or metastasectomy in gastric cancer patients with synchronous metastasis: a population-based study using propensity score matching and coarsened exac vol.10, pp.3, 2013, https://doi.org/10.7150/jca.28842