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Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 5/2019

09.05.2019 | Original Article

Is curative gastrectomy justified for gastric cancer with cytology positive as the only stage IV factor?

verfasst von: Shuhei Komatsu, Yasuhiro Shioaki, Hirotaka Furuke, Atsuki Ohta, Ryota Tsuji, Sachie Tanaka, Tatsuya Kumano, Ken-ichiro Imura, Katsumi Shimomura, Jun Ikeda, Fumihiro Taniguchi, Yasuo Ueshima, Chol Joo Lee, Eiichi Deguchi, Eito Ikeda, Eigo Otsuji

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 5/2019

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Abstract

Aims

The prognosis of patients with gastric cancer and stage IV factors is poor. However, several recent studies have identified that curative surgery followed by S-1 chemotherapy for cytology positive (CY1) only patients contributed to a better prognosis. This study was designed to compare the prognosis between curative and palliative gastrectomy followed by chemotherapy in CY1 only stage IV gastric cancer.

Methods

Between 2001 and 2016, 1507 patients underwent gastrectomy for gastric cancer. Of these, 51 consecutive patients with only CY1 factor who underwent gastrectomy followed by chemotherapy were enrolled in this study.

Results

(1) Twenty three (45%) patients underwent curative D2 or D2+ gastrectomy, and the remaining 28 (55%) patients underwent palliative gastrectomy, followed by S-1 based or another historical recommended chemotherapy postoperatively. (2) Compared with patients undergoing palliative gastrectomy, patients undergoing curative gastrectomy had a significantly better prognosis (P = 0.042; median survival time: curative vs. palliative, 22.6 months vs. 11.8 months) and a lower incidence of recurrences (P = 0.091). Two- and five-year overall survival rates of patients following curative gastrectomy were 48.2% and 18.2%, respectively. A multivariate analysis showed that venous invasion [P = 0.006; hazard ratio (HR), 3.70 (95% CI: 1.27–9.43)] and curative gastrectomy [P < 0.005; HR, 0.28 (95% CI: 0.12–0.87)] were independent prognostic factors.

Conclusion

Curative gastrectomy followed by chemotherapy might be justified to improve the prognosis of patients with only CY1 Stage IV gastric cancer.
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Metadaten
Titel
Is curative gastrectomy justified for gastric cancer with cytology positive as the only stage IV factor?
verfasst von
Shuhei Komatsu
Yasuhiro Shioaki
Hirotaka Furuke
Atsuki Ohta
Ryota Tsuji
Sachie Tanaka
Tatsuya Kumano
Ken-ichiro Imura
Katsumi Shimomura
Jun Ikeda
Fumihiro Taniguchi
Yasuo Ueshima
Chol Joo Lee
Eiichi Deguchi
Eito Ikeda
Eigo Otsuji
Publikationsdatum
09.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 5/2019
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-019-01791-0

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