Post progression survival analysis of metastatic gastric and gastroesophageal junction cancer patients after second-line treatment

Purpose : The aim of this study was to define the factors that affect response and post-progression survival of metastatic gastric cancer (MGC) and gastroesophageal junction cancer (GEJ) patients treated with second-line chemotherapy. Methods : We retrospectively reviewed the data of 59 patients with MGC or GEJ adenocarcinoma who received second-line treatment. Results : The median age was 54 years old (26-77). Response to second-line treatment was strongly associated with disease control with first-line treatment (p < 0.01). Median progression-free survival (PFS), overall survival (OS) and post-progression survival (PPS) were 3.2 (95% CI : 2.63-3.80), 6.5 (95% CI : 3.78-9.35) and 2.7 months (95% CI : 1.89-3.68), respectively. PFS (r = 0.55, p < 0.01) and PPS (r = 0.89, p < 0.01) were correlated with OS. Response to second-line treatment was independently related to PFS (HR : 0.12 95% CI : 0.53-0.26, p < 0.001). Having an ECOG 0 performance status (HR : 0.42; 95% CI : 0.21-0.86, p = 0.02) and response to second-line therapy (HR : 0.47; 95% CI : 0.25-0.85, p = 0.01) were independently associated with OS. Conclusion : PPS and PFS were correlated with OS after second-line treatment of MGC. Response to second-line treatment prolonged OS by increasing PFS, and having an ECOG 0 PS prolonged OS by increasing PPS.