Laparoscopic gastrectomy and metastasectomy for stage IV gastric cancer

Min, Sangkee; Won, Yongjoon; Lee, Kanghaeng; Youn, Sang Il; Kim, Guowei; Park, Young Suk; Ahn, Sang-Hoon; Park, Do Joong; Kim, Hyung‐Ho

doi:10.1007/s00464-020-07592-7

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…GC is a major cause of cancer mortality worldwide (1), and the clinical stage is one of the key factors affecting the prognosis (13)(14)(15). Although many previous studies have investigated the prognosis of patients with stage IV GC (9,(16)(17)(18)(19), little is known about early death. To the best of our knowledge, the present study is the first to explore the early mortality and associated factors among stage IV GC patients.…”

Section: Discussionmentioning

confidence: 99%

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The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Chen

2020

J Gastrointest Oncol

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Background: Although advances in the treatment of stage IV gastric cancer (GC) patients, some patients were observed to die within 3 months of initial diagnosis. The present study aimed to explore the early mortality and risk factors for stage IV GC and further develop nomograms.Methods: A total of 2,174 eligible stage IV GC patients were selected from the Surveillance, Epidemiology, and End Results database. Logistic regression analyses were used to determine the risk factors and develop the nomograms to predict all-cause early death and cancer-specific early death. The predictive performance of the nomograms was assessed by receiver operating characteristic curves (ROC), calibration plots and decision curve analyses (DCA) in both training and validation cohorts.Results: Of 2,174 patients enrolled, 708 died within 3 months of initial diagnosis (n=668 for cancerspecific early death). Early mortality remained stable from 2010-2015. Non-Asian or Pacific Islander (API) race, poorer differentiation, middle sites of the stomach, no surgery, no radiotherapy, no chemotherapy, lung metastases and liver metastases were associated with high risk of both all-causes early death and cancerspecific early death. The nomograms constructed based on these factors showed favorable sensitivity, with the area under the ROC range of 0.816-0.847. The calibration curves and DCAs also exhibited adequate fit and ideal net benefit in prediction and clinical application.Conclusions: Approximately one-third of stage IV GC patients experienced early death. These associated risk factors and predictive nomograms may help clinicians identify the patients at high risk of early death and be the reference for treatment choices.

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Section: Discussionmentioning

confidence: 99%

“…Zhang et al and Ulanja et al reported that the API had a higher rate of surgery and radiation than patients of other races (33,34). Aggressive treatment could effectively reduce the risk of early death (18). More researches are needed to explore the reasons behind survival differences between different races in the future.…”

Section: Discussionmentioning

confidence: 99%

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Chen

2020

J Gastrointest Oncol

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“…Patients with stage IV gastric cancer benefit from palliative surgical resection ( 24 – 27 ). Min et al ( 28 ) concluded that in patients with stage IV gastric cancer, radical gastrectomy may be an option. In certain patients with stage IV gastric cancer, laparoscopic gastrectomy is safe and viable.…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of surgical resection for stage IV gastric cancer: A SEER-based propensity score-matched analysis

Sun

Nan

2022

Front. Surg.

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BackgroundGastric cancer (GC) is a major malignancy worldwide, and its incidence and mortality rate are increasing year by year. Clinical guidelines mainly use palliative drug combination therapy for stage IV gastric cancer. In accordance with some small sample studies, surgery can prolong survival. There is no uniform treatment plan for stage IV gastric cancer. This study focused on collecting evidence of the survival benefit of cancer-directed surgery (CDS) for patients with stage IV gastric cancer by analyzing data from a large sample.MethodsData on patients with stage IV gastric cancer diagnosed between 2010 and 2015 was extracted and divided into CDS and no-CDS groups using the large dataset in the Surveillance, Epidemiology, and End Results (SEER) database. With bias between the two groups minimized by propensity score matching (PSM), the prognostic role of CDS was studied by the Cox proportional risk model and Kaplan-Meier.ResultsA total of 6,284 patients with stage IV gastric cancer were included, including 514 patients with CDS who were matched with no-CDS patients according to propensity score (1:1), resulting in the inclusion of 432 patients each in the CDS and no-CDS groups. The results showed that CDS appeared to prolong the median survival time for stage IV gastric cancer (from 6 months to 10 months). Multifactorial analysis showed that poorly differentiated tumors (grades III-IV) significantly affected patient survival, and chemotherapy was a protective prognostic factor.ConclusionThe findings support that CDS can provide a survival benefit for stage IV gastric cancer. However, a combination of age, underlying physical status, tumor histology, and metastatic status should be considered when making decisions about CDS, which will aid in clinical decision-making.

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“…Min et al compared laparoscopic and open radical gastrectomy with maximum metastasectomy in patients with stage IV GC. 35 The authors implied that radical gastrectomy with maximum metastasectomy could have a potential role in stage IV GC. After comparing those who underwent the gastrectomy plus chemotherapy group in the REGATTA trial with those who met the criteria of the REGATTA trial in this study cohort, the 2‐y OSR and mean survival time was 55.6%, and 26.8 mo, which was twice as high as those of the REGATTA trial (25.1% and 14.3 mo, respectively); this discrepancy can be attributed to the extent of surgery.…”

Section: Minimally Invasive Surgery In Unresectable or Borderline Res...mentioning

confidence: 99%

Minimally invasive surgery in advanced gastric cancer

Lee

Kim

2022

Annals of Gastroent Surgery

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According to GLOBOCAN 2018, there were over 1 000 000 new cases of GC in 2018 and an estimated 783 000 deaths, making it the fifth most frequently diagnosed cancer and the third leading cause of cancer death worldwide. 1 The traditional treatment option for GC is surgical resection, which includes gastrectomy with D2 lymph node dissection after laparotomy. However, several less invasive procedures and minimally invasive surgeries (MISs) have been developed to reduce the invasiveness of surgery and improve patients' quality of life. In 1994, Dr. Seigo Kitano first introduced laparoscopyassisted distal gastrectomy (LADG) for early gastric cancer (EGC).Since then, based on many studies and clinical trials, the laparoscopic approach has become increasingly established in GC surgery. 2 In addition, even more popular than LADG, a totally laparoscopic gastrectomy technique has been developed to reduce surgical wound and surgical stress compared to laparoscopic-assisted methods. In 2009, Ikeda et al reported the advantages of totally laparoscopic distal gastrectomy (TLDG) over LADG as less invasive, secure ablation of the tumor with the stomach, and safe anastomosis. 3 Chen et al reported that TLDG had a longer surgery time but less bleeding and shorter hospitalization than open gastrectomy (OG) in a systematic review including one randomized controlled trial (RCT) and 13 observational studies. 4 In eastern Asian countries, several study groups have been established as a platform to organize and conduct prospective RCTs in each country; for example, the Japanese Clinical Oncology Study Group (JCOG) in Japan, the Korean Laparoscopic Gastrointestinal Surgical Study Group (KLASS) in South Korea, and the Chinese Laparoscopic Gastrointestinal Surgical Study Group (CLASS) in China to evaluate the safety and feasibility of MIS on GC. In Korea, the KLASS-01 trial has proven the efficacy of laparoscopic distal gastrectomy (LDG) vs open subtotal gastrectomy for clinical stage I GC with better short-term outcomes and equivalent long-term survival. 5,6 In Japan, similar results have been demonstrated for LDG vs open distal gastrectomy for clinical stage IA/IB GC in the JCOG 0912 trial. 7,8 In China, the safety of laparoscopic total gastrectomy

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Laparoscopic gastrectomy and metastasectomy for stage IV gastric cancer

Cited by 7 publications

References 19 publications

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

The incidence, risk factors and predictive nomograms for early death among patients with stage IV gastric cancer: a population-based study

Survival benefit of surgical resection for stage IV gastric cancer: A SEER-based propensity score-matched analysis

Minimally invasive surgery in advanced gastric cancer

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