Gastric Adenocarcinoma With Distant Metastasis

Sarela, Abeezar; Yelluri, Shashidhar

doi:10.1001/archsurg.142.2.143

Cited by 47 publications

(41 citation statements)

References 26 publications

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“…A recent meta-analysis of randomized trials that compared chemotherapy and best supportive care in patients with MGC revealed that chemotherapy was more beneficial than best supportive care alone with respect to OS and quality of life [20]. However, the role of surgery (debulking gastrectomy or gastrectomy plus metastasectomy) in GC patients with distant metastasis is still controversial [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The results of our study suggest that surgery may be beneficial in MGC patients when combined with chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…GC mortality has remained high due to the frequent initial presentation with distant metastasis. Although surgery is mandatory for the cure of locoregional GC, the role of surgery for metastatic gastric cancer (MGC) is controversial [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. For patients with MGC, palliative chemotherapy and best supportive care are considered the only standard treatment to achieve extension of survival and palliation of symptoms [19].…”

Section: Introductionmentioning

confidence: 99%

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Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

et al. 2011

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Background This study was performed to investigate the role of surgery in patients with gastric cancer and distant metastases who had received systemic chemotherapy. Methods Patients with newly diagnosed gastric cancer and synchronous distant metastases who had received chemotherapy (n = 274) were categorized into 3 groups according to the surgical treatment rendered: complete gross resection of both primary and metastatic sites (group A; n = 42); debulking gastrectomy (group B; n = 47); and chemotherapy without debulking (group C; n = 185). Results The median overall survival of all patients was 11.8 months. The median overall survival and 3-year survival rates were 28.0, 15.5, and 9.0 months and 42.8, 8.1, and 3.5% in groups A, B, and C, respectively. In group A, patients with peritoneal seeding, intra-abdominal distant lymph nodes, or ovarian or hepatic metastases underwent complete gross resection, and 12 (29%) were disease-free at the time of the last analysis (median follow-up duration, 29.1 months). On multivariate analysis, the adjusted hazard ratios for death were 0.27 (P \ 0.001) and 0.64 (P = 0.024) for groups A and B, respectively, as compared to group C.Conclusions Our study suggests survival benefits of debulking gastrectomy or gastrectomy plus metastasectomy in gastric cancer patients with distant metastases receiving systemic chemotherapy. Prolonged disease-free survival was observed after complete resection (gastrectomy plus metastasectomy) that may lead to cure in some patients. Well-designed prospective trials of the role of multidisciplinary approaches combining chemotherapy and surgery are needed to confirm the observations of our study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

et al. 2011

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“…A previous cohort study has shown that only 7% of gastric cancer patients with metastases not undergoing gastrectomy needed intervention due to bleeding (Sarela et al 2007). Their median survival time was similar to those of a previous series of patients undergoing gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Palliative radiation therapy for hemorrhage of unresectable gastric cancer: a single institute experience

Hashimoto

Mayahara

Takashima

et al. 2009

J Cancer Res Clin Oncol

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“…Therefore, it may be argued that such a subsequent intervention could have been prevented by preemptive gastrectomy. In this regard, Sarela et al recently reported that 25% of nonoperatively treated patients required a subsequent intervention for a primary tumor-related complication, with no intervention-related mortality [15]. A large, prospective study of surgical palliation reports no difference in the frequency of symptom resolution with endoscopic procedures or operation [16].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic characteristics of gastric cancer patients who underwent noncurative gastrectomy with long-term survival

Saito

Yamada

Tsujitani

et al. 2008

Langenbecks Arch Surg

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Gastric Adenocarcinoma With Distant Metastasis

Cited by 47 publications

References 26 publications

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

Palliative radiation therapy for hemorrhage of unresectable gastric cancer: a single institute experience

Clinicopathologic characteristics of gastric cancer patients who underwent noncurative gastrectomy with long-term survival

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