Keywords
3gastrektomia
4pronostikoa
5biziraupena
urdaileko minbizia
How to Cite
Abstract
Introduction. The objective of this work is to assess the impact of gastrectomy on the prognosis of metastatic stomach cancer. In fact, metastatic gastric cancer has a poor prognosis and it is not managed uniformly. Although there is increasing evidence that chemotherapy prolongs survival in this disease, it is not clear whether removal of the primary tumour can benefit prognosis. On the other hand, given that the rest of the palliative treatments lose efficacy during the prolongation of life, gastrectomy may be an adequate palliative measure, since in addition to prolonging survival, it would improve the quality of life in well-selected patients.
Methodology. The data of patients diagnosed with metastatic stage of stomach cancer in the years 2005-2014 (N = 348) are collected from the Hospital de Cruces Euskadi tumour registry. At the same time, during this period, the prospective database completed in the General Surgery Service of the Cruces Hospital was used to obtain the data of these patients operated on there. To ensure balanced characteristics of patients who had gastrectomy and those who did not have gastrectomy, 1:1 matching analysis was used. Data to analyse survival have been analysed using Kaplan-Meier and the Cox proportional hazard model. Cox analysis has been used to select independent prognostic factors on the nomogram.
Results. Median survival in gastrectomized patients was 8 months longer. The survival percentages for 6 months, 1 year and 2 years have been respectively 35,7%, 16,3%, 7,4% (not gastrectotomized) and 76,9%, 47,7%, 21,5% (gastrectotomized). In multivariable analyses, gastrectomy has been associated with better overall survival (HR= 0,17, CI95%= 0,11-0,29, p<0,001).
Conclusion. In well-selected patients, gastrectomy has been shown to improve survival in metastatic gastric cancer. However, a randomized prospective study would be needed to address the limits of this study.
References
SEOM: Las cifras de cancer en España 2021 [Internet]. Madrid: Sociedad Española de Oncología Médica; D.L.2021 [Kontsulta: 2023-05-29]. 20 or. Eskuraga-rri:https://seom.org/images/Cifras_del_cancer_en_Espnaha_2021.pdf
Kinoshita J, Yamaguchi T, Moriyama H, Fushida S. Current status of conversion surgery for stage IV gastric cancer. Surg Today. 2021 Aza;51(11):1736-1754.
SEOM [Internet]. Madrid: Sociedad Española de Oncología Médica; [2022]. Cán-cer gástrico; [Kontsulta: 2023-05-29. 14 or. Eskuragarri: https://seom.org/info-sobre-el-cancer/estomago?start=1
American Society of Clinical Oncology (ASCO): Cancer.net [Internet]. Alexandría (Virginia): ASCO; © 2005-2022. Cáncer de estomago. [2019] [Kontsulta: 2023-05-29]; [2019]. Eskuragarri: https://www.cancer.net/es/tipos-HYPERLINK "https://www.cancer.net/es/tipos-de-cancer/cancer-de-"de-cancer/cancer-de-estomago/estad%C3%ADsticas.
Guzmán BS, Norero ME. Cáncer gástrico. RMCLC. 2014; 2014; 25(1):105-113.
Hierro GA, de Uime FEP, González FL. Comportamiento clínico, epidemiologico, endocopico e histologico del cancer gástrico de tipo epitelial. Rey Cubana Iny Bi-omed.
Cancer Genome Atlas Research Network. Comprehensive molecular characteriza-tion of gastric adenocarcinoma. Nature. 2014;513(7517):202-9.
Hu B, El Hajj N, Sittler S, Lammert N, Barnes R, Meloni-Ehrig A. Gastric cancer: Classification, histology and application of molecular pathology. J Gastrointest Oncol. 2012 Ira;3(3):251-61.
Quintana A, Sarriugarte A, Agirre L. Kirurgia orokorreko eskuliburua. [Leioa?]: EHUko argitalpen zerbitzua, D.L. 2020; 528 or.
Baiocchi GL, Giacopuzzi S, Reim D, Piessen G, Costa PMD, Reynolds JV, Meyer HJ, Morgagni P, Gockel I, Santos LL, Jensen LS, Murphy T, D'Ugo D, Rosati R, Fumaga-lli Romario U, Degiuli M, Kielan W, Mönig S, Kołodziejczyk P, Polkowski W, Pera M, Schneider PM, Wijnhoven B, de Steur WO, Gisbertz SS, Hartgrink
H, van Sandick JW, Botticini M, Hölscher AH, Allum W, De Manzoni G. Incidence and Grading of Complications After Gastrectomy for Cancer Using the GASTRO-DATA Registry: A European Retrospective Observational Study. Ann Surg. 2020 Aza;272(5):807-813.
He X, Lai S, Su T, Liu Y, Ding Y, Quan S, Si J, Sun L. Survival benefits of gastrectomy in gastric cancer patients with stage IV: a population – based study. Oncotarget, 2017 Aza 20;8(63): 106577-106586.
Ebinger SM, Warschkow R, Tarantino I, Schmied BM, Güller U, Schiesser M. Mo-dest overall survival improvements from 1998 to 2009 in metastatic gastric can-cer patients: a population-based SEER analysis. Gastric Cancer. 2016 Uzt;19(3):723-34.
He MM, Zhang DS, Wang F, Wang ZQ, Luo HY, Jin Y, Wei XL, Xu RH. The role of non-curative surgery in incurable, asymptomatic advanced gastric cancer. PLoS One. 2013 Abe16;8(12):e83921.
Lasithiotakis K, Antoniou SA, Antoniou GA, Kaklamanos I, Zoras O. Gastrectomy for stage IV gastric cancer. a systematic review and meta-analysis. Anticancer Res. 2014 Mai;34(5):2079-85.
Sun J, Song Y, Wang Z, Chen X, Gao P, Xu Y, Zhou B, Xu H. Clinical significance of palliative gastrectomy on the survival of patients with incurable advanced gastric cancer: a systematic review and meta-analysis. BMC Cancer. 2013 Abe 5;13:577.
Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, Iwasaki Y, Hyung WJ, Takagane A, Park DJ, Yoshikawa T, Hahn S, Nakamura K, Park CH, Kurokawa Y, Bang YJ, Park BJ, Sasako M, Tsujinaka T; REGATTA study investigators. Gastrec-tomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. Lancet Oncol. 2016 Mar;17(3):309-318.
Al-Batran SE, Homann N, Pauligk C, Illerhaus G, Martens UM, Stoehlmacher J, Schmalenberg H, Luley KB, Prasnikar N, Egger M, Probst S, Messmann H, Moeh-ler M, Fischbach W, Hartmann JT, Mayer F, Höffkes HG, Koenigsmann M, Arnold D, Kraus TW, Grimm K, Berkhoff S, Post S, Jäger E, Bechstein W, Ronellenfitsch U, Mönig S, Hofheinz RD. Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroeso-phageal Junction Cancer: The AIO-FLOT3 Trial. JAMA Oncol. 2017 Ira 1;3(9):1237-1244.
Al-Batran SE, Goetze TO, Mueller DW, Vogel A, Winkler M, Lorenzen S, Novotny A, Pauligk C, , Homann N, Jungbluth T, Reissfelder C, Caca K, Retter S, Horndasch E, Gumpp J, Bolling C, Fuchs KH, Blau W, Padberg W, Pohl M, Wunsch A, Michl P, Mannes F, Schwarzbach M, Schmalenberg H, Hohaus M, Scholz C, Benckert C, Knorrenschild JR, Kanngießer V, Zander T, Alakus H, Hofheinz RD, Roedel C, Shah MA, Sasako M, Lorenz D, Izbicki J, Bechstein WO, Lang H, Moenig SP. The RENAI-SSANCE (AIO-FLOT5) trial: effect of chemotherapy alone vs. chemotherapy follo-wed by surgical resection on survival and quality of life in patients with limited-metastatic adenocarcinoma of the stomach or esophagogastric junction - a phase III trial of the German AIO/CAO-V/CAOGI. BMC Cancer. 2017 Abe 28;17(1):893.
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