Prognostic Indicators in Stage IV Surgically Treated Gastric Cancer Patients: A Retrospective Multi-Institutional Study

Dig Surg. 2019;36(4):331-339. doi: 10.1159/000488775. Epub 2018 Jun 26.

Abstract

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery.

Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated.

Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors.

Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.

Keywords: Advanced stage; Gastric cancer; Metastatic disease; Non-curative gastrectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery*
  • Aged
  • Chemotherapy, Adjuvant
  • Female
  • Gastrectomy / methods*
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Survival Rate