Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?

Chang Min Lee; In Keun Choi; Jong-Han Kim; Da Won Park; Jun Suk Kim; Seong-Heum Park

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저자정보: Chang Min Lee (Korea University Medical Center) In Keun Choi (Korea University Medical Center) Jong-Han Kim (Korea University Medical Center) Da Won Park (Korea University Medical Center) Jun Suk Kim (Korea University Medical Center) Seong-Heum Park (Korea University Medical Center)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.92 No.1

발행연도: 2017.1

수록면: 23 - 29 (7page)

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Purpose: The purpose of this study is to suggest a treatment strategy for stage IV gastric cancer by investigating the behavioral difference between initially and recurrent metastatic disease.
Methods: We reviewed the medical records of the patients who underwent chemotherapy alone for metastatic gastric cancer between January 2006 and September 2013. Patients were divided into those who underwent chemotherapy for metastatic disease since initial diagnosis (IM group) and for metastatic recurrence after curative surgery (RM group). Survival and causes of death were compared between the 2 groups, and significant prognostic factors were also investigated.
Results: A total of 170 patients were enrolled in this study. Of these patients, 104 were included in the IM group and 66 in the RM group. Overall survival of the IM group did not differ from that of RM (P = 0.569). In the comparison of the causes of death, the IM group had a greater tendency to die from bleeding (P = 0.054) and pneumonia (P = 0.055). In multivariate analysis, bone metastasis (P < 0.001; HR = 2.847), carcinoma peritonei (P = 0.047; HR = 1.766), and the frequency of chemotherapy (P < 0.001; HR = 0.777) were significantly associated with overall survival of IM group.
Conclusion: Disease-burden mainly contributes to the prognosis of metastatic gastric cancer, although noncurative gastrectomy may be helpful in reducing the mortality of initially metastatic disease. Therefore, disease-burden should be also prioritized in determining the treatment strategies for stage IV gastric cancer.

#Metastasis #Stomach neoplasms #Gastrectomy #Prognosis

참고문헌 (30)

참고문헌 신청

[학술지(정기간행물)] - Ferlay J / 2015 / Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136 (5) : E359 ~ E386

[학술지(정기간행물)] - Lehnert T / 2002 / Surgical therapy for loco-regional recurrence and distant metastasis of gastric cancer / Eur J Surg Oncol 28 : 455 ~ 461

[학술지(정기간행물)] - Kita K / 2009 / A case of long-term survival of unresectableadvanced gastric cancer due to chemotherapy / Gan To Kagaku Ryoho 36 : 2281 ~ 2283

[학술지(정기간행물)] - Tanida T / 2008 / Two cases of long-term survival with CY1, stage IV gastric cancer due to surgery and postoperative chemotherapy / Gan To Kagaku Ryoho 35 : 2063 ~ 2065

[학술지(정기간행물)] - Tomimatsu H / 2007 / Two cases of stage IV gastric cancer who underwent total gastrectomy and achieved long-term survival by sequential chemotherapy / Gan To Kagaku Ryoho 34 : 2291 ~ 2295

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이 논문의 저자 정보

Chang Min Lee

소속기관 Korea University Ansan Hospital

주요연구분야 자연과학 > 생활과학 공학 > 조선해양공학

논문수 35 이용수 1,223

In Keun Choi

소속기관 Korea University Medical Center