Efficacy of conversion gastrectomy following docetaxel, cisplatin, and S-1 therapy in potentially resectable stage IV gastric cancer

Koyama, Jun; Fushida, Sachio; Tsukada, Tomoya; Oyama, Katsunobu; Okamoto, Koichi; Makino, Isamu; Nakamura, Keisuke; Miyashita, Tomoharu; Tajima, Hidehiro; Takamura, Hiroyuki; Ninomiya, Itasu; Ohta, Tetsuo

doi:10.1016/j.ejso.2015.04.021

Cited by 60 publications

(70 citation statements)

References 23 publications

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“…Some of previous studies suggested that SRCC is less chemo‐sensitive than non‐SRCC cancers, so the value of palliative gastrectomy plus chemotherapy may be even higher in stage IV gastric SRCC than NOS. In addition, several recently published studies proved that improved long‐term survival was observed among stage IV GC patients who underwent conversion surgery (primary tumor resection performed in initially unresectable metastatic cancer after responding to chemotherapy) . This also cast light on the therapeutic role of palliative surgery strategies in stage IV gastric SRCC patients.…”

Section: Discussionmentioning

confidence: 94%

Survival benefit of palliative gastrectomy followed by chemotherapy in stage IV gastric signet ring cell carcinoma patients: A large population‐based study

et al. 2019

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Background Stage IV gastric signet ring cell carcinoma (SRCC) is a type of malignant gastric cancer (GC) with poorer survival compared to metastatic non‐SRCC gastric cancer (NOS). However, chemotherapy alone was unable to maintain long‐term survival. This study aimed to evaluate survival benefit of palliative gastrectomy plus chemotherapy (PG+C) for metastatic gastric SRCC. Methods We obtained data on gastric cancer patients between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Statistical methods included χ2 tests, Kaplan‐Meier curves, COX models, propensity score matching (PSM) and subgroup analysis. Results Among 27 240 gastric cancer patients included, 4638 (17.03%) were SRCC patients. The proportion of patients with younger age, female gender, poorly differentiated grade and M1 stage was higher in SRCC than in NOS (P < .001). Multivariate analysis revealed that multiple metastatic sites (HR = 1.39, 95% CI: 1.14‐1.69, P = .001) was associated with increased mortality risk in metastatic SRCC. Median survival time was improved in metastatic SRCC receiving PG+C compared to PG/C alone (13 vs 7 months, P < .001). Notably, in subgroup analysis, 13 of 17 groups of metastatic SRCC patients with PG+C had prolonged overall survival compared to chemotherapy alone, especially for those with only one metastatic site (HR = 0.61, 95% CI: 0.51‐0.73, P < .001). Conclusions Our results suggested that there exists at least a selective group of stage IV gastric SRCC patients, who could benefit from palliative gastrectomy followed by chemotherapy compared to chemotherapy alone. Further prospective trials are needed to support our conclusion.

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Section: Discussionmentioning

confidence: 94%

Survival benefit of palliative gastrectomy followed by chemotherapy in stage IV gastric signet ring cell carcinoma patients: A large population‐based study

et al. 2019

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“…However, data from the eastern experience and the possibility of more extensive surgeries with low morbidity have led the physicians to be more aggressive in the treatment of metastatic disease. Curative outcomes have been reported with an R0 resection in potentially/marginally resectable cases, although they are initially metastatic diseases, referred to as conversion treatment (30)(31)(32). Although potentially resectable cases, such as single liver metastasis or 16a2-b1 paraaortic lymph node metastasis are technically suitable for surgical resection, we prefer preoperative chemotherapy followed by surgical resection.…”

Section: Management Of Metastatic Diseasementioning

confidence: 99%

Recent trends of gastric cancer treatment in Turkey

Güner

2017

Transl. Gastroenterol. Hepatol.

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Gastric cancer is the fifth most common type of cancer and is the fourth most common death due to cancer in Turkey. Incidence and mortality rates are one of the highest among European countries. Despite the high rates, management of gastric cancer is still an issue of debate in Turkey and national guidelines have yet to be established. While the treatment plan following the diagnosis of gastric cancer is determined by a multidisciplinary meeting at high-volume centers, the plan in the majority of cases in Turkey is decided based on the decision of an individual physician. The primary goal of the treatment strategy is to obtain the best oncological outcomes and quality of life within the acceptable treatment-related morbidity. Therefore, R0 resection is intended by using standardized surgery with an individualized approach, while avoiding surgery if a curative resection is not possible. In this review, presenting on the recent trends of gastric cancer treatment including surgical, endoscopic, adjuvant/neoadjuvant and conversion treatment options in Turkey are aimed by exploring the institutional approach.

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“…However, several novel combined chemotherapy regimens occasionally allow conversion of initially unresectable gastric cancer to resectable cancer. Additional (conversion) surgery after response to chemotherapy results in long-term survival in selected patients (2)(3)(4)(5)(6)(7). We have previously reported that patients with unresectable gastric cancer obtained survival benefit from S-1-based chemotherapy, and subsequent conversion surgery (8).…”

mentioning

confidence: 99%

Efficacy of Conversion Surgery Following S-1 plus Cisplatin or Oxaliplatin Chemotherapy for Unresectable Gastric Cancer

Fukuchi

Mochiki

Ishiguro

et al. 2017

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Efficacy of conversion gastrectomy following docetaxel, cisplatin, and S-1 therapy in potentially resectable stage IV gastric cancer

Abstract: Patients with potentially resectable disease had a remarkably good prognosis among stage IV gastric cancer patients, and might be ideal candidates for conversion gastrectomy following DCS therapy.

Cited by 60 publications

References 23 publications

Survival benefit of palliative gastrectomy followed by chemotherapy in stage IV gastric signet ring cell carcinoma patients: A large population‐based study

Survival benefit of palliative gastrectomy followed by chemotherapy in stage IV gastric signet ring cell carcinoma patients: A large population‐based study

Recent trends of gastric cancer treatment in Turkey

Efficacy of Conversion Surgery Following S-1 plus Cisplatin or Oxaliplatin Chemotherapy for Unresectable Gastric Cancer

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