Clinical Significance of Conversion Surgery for Gastric Cancer with Peritoneal Dissemination: A Retrospective Study

被引：13

作者：

Arigami, Takaaki ^{[1
]}

Matsushita, Daisuke ^{[2
]}

Okubo, Keishi ^{[2
]}

Sasaki, Ken ^{[2
]}

Noda, Masahiro ^{[2
]}

Kita, Yoshiaki ^{[2
]}

Mori, Shinichiro ^{[2
]}

Kurahara, Hiroshi ^{[2
]}

Yanagita, Shigehiro ^{[2
]}

Uenosono, Yoshikazu ^{[2
]}

Ishigami, Sumiya ^{[2
]}

Ohtsuka, Takao ^{[2
]}

Natsugoe, Shoji ^{[2
]}

机构：

[1] Kagoshima Univ, Dept Oncobiol Surg, Grad Sch Med & Dent Sci, 8-35-1 Sakuragaoka, Kagoshima 8908520, Japan

[2] Kagoshima Univ, Dept Digest Surg Breast & Thyroid Surg, Grad Sch Med & Dent Sci, Kagoshima, Japan

来源：

ONCOLOGY | 2020年 / 98卷 / 11期

基金：

日本学术振兴会;

关键词：

Conversion surgery; Gastric cancer; Peritoneal dissemination; THERAPY;

D O I：

10.1159/000509530

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: Although chemotherapy has been clinically recommended as the initial treatment for patients with peritoneal dissemination of gastric cancer, poor prognosis has been noted among the same patients. However, the prognostic significance of conversion surgery after chemotherapy remains unclear. The present study therefore aimed to assess the clinical impact of conversion surgery among patients with peritoneal dissemination of gastric cancer. Methods: A total of 93 patients with peritoneal dissemination of gastric cancer undergoing chemotherapy between February 2002 and October 2019 were retrospectively enrolled and subsequently divided into progressive disease (PD) and non-PD groups based on tumor response to chemotherapy. Results: Among the included patients, 17 developed distant metastases at another site besides peritoneal dissemination. Based on tumor response, 24 and 69 patients were determined to have PD and non-PD, respectively, with the former having significantly poorer prognosis than the latter (p < 0.0001). A total of 19 patients underwent conversion surgery after chemotherapy, with the presence or absence of conversion surgery being significantly correlated with age, first-line chemotherapy regimen, and tumor response (p = 0.0134, p = 0.0337, and p = 0.0024, respectively). Patients in the non-PD group who underwent conversion surgery or chemotherapy alone had 3-year overall survival rates of 55.6 and 6.6%, respectively. Multivariate analysis identified conversion surgery alone as an independent prognostic factor in the non-PD group (p < 0.0001). Conclusion: Our retrospective study demonstrated that conversion surgery for gastric cancer with peritoneal dissemination might improve the prognosis of responders who developed no peritoneal dissemination after chemotherapy.

引用

页码：798 / 806

页数：9

共 21 条

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