The role of hepatectomy in the management of metastatic gastric adenocarcinoma: A systematic review

Grimes, Nathan; Devlin, Joanne M.; Dunne, Declan; Poston, Graeme J.; Fenwick, Stephen; Malik, Hassan

doi:10.1016/j.suronc.2014.08.001

Cited by 21 publications

(16 citation statements)

References 35 publications

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“…Despite curative hepatectomy, recurrence was previously reported in 62 % of patients, with most cases developing intrahepatic recurrence [29], suggesting the presence of occult intrahepatic metastases even at the time of hepatectomy. Taken together, these results indicate the difficulty of obtaining a surgical cure in patients with hepatic metastases and the necessity of effective chemotherapy to eliminate possible metastases [30]. In the current study, conversion cases with liver metastases showed good prognosis, with an MST of 22 months, suggesting that patients can obtain survival benefits from this treatment.…”

Section: Discussionsupporting

confidence: 55%

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

et al. 2016

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Background Conversion therapy is an option for unresectable metastatic gastric cancer when distant metastases are controlled by chemotherapy; however, the feasibility and efficacy remain unclear. This study aimed to assess the feasibility and efficacy of conversion therapy in patients with initially unresectable gastric cancer treated with docetaxel, cisplatin, and S-1 (DCS) chemotherapy by evaluating clinical outcomes.Methods One hundred unresectable metastatic gastric cancer patients, enrolled in three DCS chemotherapy clinical trials, were retrospectively evaluated. The patients received oral S-1 (40 mg/m 2 b.i.d.) on days 1-14 and intravenous cisplatin (60 mg/m 2 ) and docetaxel (50-60 mg/m 2 ) on day 8 every 3 weeks. Conversion therapy was defined when the patients could undergo R0 resection post-DCS chemotherapy and were able to tolerate curative surgery. Results Conversion therapy was achieved in 33/100 patients, with no perioperative mortality. Twenty-eight of the 33 patients (84.8 %) achieved R0 resection, and 78.8 % were defined as histological chemotherapeutic responders. The median overall survival (OS) of patients who underwent conversion therapy was 47.8 months (95 % CI 28.0-88.5 months). Patients who underwent R0 resection had significantly longer OS than those who underwent R1 and R2 resections (P = 0.0002). Of the patients with primarily unresectable metastases, 10 % lived [5 years. Among patients who underwent conversion therapy, multivariate analysis showed that the pathological response was a significant independent predictor for OS. Conclusions DCS safely induced a high conversion rate, with very high R0 and pathological response rates, and was associated with a good prognosis; these findings warrant further prospective investigations.

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Section: Discussionsupporting

confidence: 55%

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

et al. 2016

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“…The liver is the most common site for metastases in patients with gastric cancer [18]. The reported rate of liver resection, however, is less than 1% due to the multiple, bilateral, and extrahepatic nature of the disease [15,19].…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective study on 257 patients from 5 Japanese centers, however, 75% of patients had disease recurrence especially in the liver (72.4%) after a median interval of 7 months after resection [23]. A recent meta-analysis of retrospective studies describes a survival benefit, though [19]. Even in gastric cancer with peritoneal carcinomatosis, maximal cytoreductive surgery combined with regional hyperthermic intraperitoneal and systemic chemotherapy seems to achieve prolonged survival in selected patients [24].…”

Section: Discussionmentioning

confidence: 99%

Oligometastatic Disease in Upper Gastrointestinal Cancer - How to Proceed

et al. 2017

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Background: In the present study we review and discuss the current evidence and suggest how to proceed in the management of oligometastatic disease in upper gastrointestinal cancer. Methods: An electronic search of the PubMed database for relevant articles was performed. Results: Both the search for ‘oligometastasis', ‘oligometastases', ‘oligometastatic', ‘oligometastatic disease' as well as ‘esophageal' and ‘esophageal cancer' and the search for ‘oligometastasis', ‘oligometastases', ‘oligometastatic', ‘oligometastatic disease' as well as ‘gastric', ‘gastric cancer', ‘stomach', and ‘stomach cancer' yielded very few studies. Most data need to be extrapolated in general studies on oligometastatic diseases of different origins. No randomized controlled trial could be found. Conclusion: In the absence of data to formulate recommendations on how to proceed in the treatment of oligometastatic disease in upper gastrointestinal cancer, a more aggressive treatment of oligometastatic disease can be considered in patients whose tumors show a more favorable neoplastic behavior after the ‘test of time'. The RENAISSANCE study will certainly deliver important data regarding this aspect.

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“…Analyzing surgical treatment in the case of distant metastases, we must also mention treatment of liver metastases from GC. No trials have been performed in this field, and a recent review by Grimes et al [101] was based on 17 retrospective studies. The solitary disease patients had better OS than those with metachronous disease, and patients with metachronous disease had better prognosis than those with synchronous disease.…”

Section: Metastatic Gcmentioning

confidence: 99%

Multimodal treatment of gastric cancer in the west: Where are we going?

Marrelli

Połom

Manzoni

et al. 2015

WJG

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The incidence of gastric cancer (GC) is decreasing worldwide, especially for intestinal histotype of the distal third of the stomach. On the contrary, proximal location and diffuse Lauren histotype have been reported to be generally stable over time. In the west, no clear improvement in long-term results was observed in clinical and population-based studies. Results of treatment in these neoplasms are strictly dependent on tumor stage. Adequate surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however, results are still unsatisfactory for advanced stages (Ⅲ and Ⅳ), for which additional treatments could provide a survival benefit. This implies a tailored approach to GC. The aim of this review was to summarize the main multimodal treatment options in advanced resectable GC. Perioperative or postoperative treatments, including chemotherapy, chemoradiotherapy, targeted therapies, and hyperthermic intraperitoneal chemotherapy have been reviewed, and the main ongoing and completed trials have been analyzed. An original tailored multimodal approach to non-cardia GC has been also proposed.

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The role of hepatectomy in the management of metastatic gastric adenocarcinoma: A systematic review

Cited by 21 publications

References 35 publications

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

Oligometastatic Disease in Upper Gastrointestinal Cancer - How to Proceed

Multimodal treatment of gastric cancer in the west: Where are we going?

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