Long-term survival after pulmonary resections for multiple metastases from gastric cancer: A case report

Kojima, Hideaki; Isaka, Mitsuhiro; Shoji, Tetsuo; Machida, Nozomu; Funai, Kazuhito; Ohde, Yasuhisa

doi:10.1016/j.ijscr.2018.03.020

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…However, in their trial, Fujitani and colleagues did not consider the possibility of a complete surgical resection of both gastric cancer and metastases, limiting their comparison between chemotherapy alone versus gastrectomy plus chemotherapy in the metastatic setting. The recent literature [6][7][8][9][10][11][12][13][14][15] contrasts with the conclusion of the REGATTA Trial, showing that an integrated multidisciplinary approach including chemotherapy and surgery may offer, at least to a selected subgroup of patients, unexpected results, in particular when a radical (R0) resection can be achieved both on gastric primary and metastases. Although the power of these studies is limited by their retrospective nature, they cannot be ignored, particularly in the light of results achieved by conversion therapy.…”

Section: Introductionmentioning

confidence: 93%

Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer

Ministrini

Bencivenga

Solaini

et al. 2020

Cancers

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Background/Aim: This work explored the prognostic role of curative versus non-curative surgery, the prognostic value of the various localizations of metastatic disease, and the possibility of identifying patients to be submitted to aggressive therapies. Patients and Methods: Retrospective chart review of stage IV patients operated on in our institutions. Results: Two hundred and eighty-two patients were considered; 73.4% had a single metastatic presentation. In 117 cases, a curative (R0) resection of primary and metastases was possible; 75 received a R1 resection and 90 a palliative R2 gastrectomy. Surgery was integrated with chemotherapy in multiple forms: conversion therapy, HIPEC, neo-adjuvant and adjuvant treatment. Median overall survival (OS) of the entire cohort was 10.9 months, with 14 months for the R0 subgroup. There was no correlation between metastasis site and survival. At multivariate analysis, several variables associated with the lymphatic sphere showed prognostic value, as well as tumor histology and the curativity of the surgical procedure, with a worse prognosis associated with a low number of resected nodes, D1 lymphectomy, pN3, non-intestinal histology, and R+ surgery. Considering the subgroup of R0 patients, the variables pT, pN and D displayed an independent prognostic role with a cumulative effect, showing that patients with no more than 1 risk factor can reach a median survival of 33 months. Conclusions: Our data show that the possibility of effective care also exists for Western patients with stage IV gastric cancer.

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Section: Introductionmentioning

confidence: 93%

Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer

Ministrini

Bencivenga

Solaini

et al. 2020

Cancers

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“…7 In this context, several retrospective studies have provided evidence of a potential benefit of gastrectomy in metastatic GC as well. [8][9][10][11][12][13][14] Although chemotherapy or chemotherapy combined with targeted therapy remains the cornerstone of the palliative treatment of advanced or metastatic GC, surgery has demonstrated survival benefit in patients with metastatic GC. Accumulating studies have revealed that liver resection in GC patients with liver metastasis is considered favorable with marked 5-year survival and could be offered to selected patients.…”

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confidence: 99%

Prognostic Value of the Site of Distant Metastasis and Surgical Interventions in Metastatic Gastric Cancer: A Population-Based Study

Xie

Chen

et al. 2020

Technol Cancer Res Treat

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Background: Studies on the prognostic significance of site-specific distant metastasis, multiple-site metastases, and the impact of surgery of the primary tumor and metastatic lesion on survival outcomes of patients with metastatic gastric cancer (GC) remain elusive. Therefore, this study aimed to investigate the prognostic significance of the site of distant metastasis among patients with metastatic GC. Furthermore, the effect of surgery of the primary tumor and metastatic lesion on the prognosis of metastatic GC was also analyzed. Methods: The data of 4,221 eligible patients, who were diagnosed with metastatic GC between 2010 and 2015, were identified from the Surveillance Epidemiology and End Results (SEER) database. Multivariate logistic regression analysis was performed to assess the association between potential prognostic factors, including the site of metastasis and surgery, and survival of patients with metastatic GC. Overall survival (OS) and cause-specific survival (CSS) were determined using the Kaplan-Meier survival curves and differences were assessed using the Log-rank test. Results: Out of the total 4,221 GC patients with definite organ metastases, 3312 patients had single-site metastasis while 909 patients had multiple-site metastases. GC patients with single-site metastasis of liver or lung exhibited better CSS and OS compared to those with bone metastasis. Furthermore, GC patients with liver metastasis benefited from surgery of both the primary and metastatic lesions, while those with lung metastasis benefited from surgery of metastasis resection only. Multivariate Cox regression analysis revealed that GC patients with single-site metastasis, well-differentiated tumors, GC patients who underwent surgery of the primary tumor and those who received chemotherapy exhibited favorable prognosis. Conclusions: The site of metastasis was an independent prognostic factor for metastatic GC. Surgery had survival benefits in certain cases of metastatic GC; however, further studies are warranted to clarify these benefits in carefully selected patients.

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“…Several studies of recurrent liver or lung metastasis from colorectal cancer report that repeated metastasectomy is effective, and current international guidelines also discuss the potential benefit of this approach [ 11 12 13 ]. By contrast, reports of repeated local therapy for recurrent metastatic lesions from gastric cancer are still extremely rare, and a review of PubMed yielded only three English reports, which are summarized alongside the current case in Table 1 [ 14 15 16 ]. In previous case reports on surgical resections of recurrent metastases from gastric cancer, the majority of the cases were lung or adrenal metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Mokuno et al [ 15 ] reported a case of 9-year survival achieved by repeated adrenalectomy of bilateral adrenal metastases from mucinous adenocarcinoma of the stomach. Kojima et al [ 16 ] documented a case of 10-year survival achieved by repeated pulmonary resection for multiple lung metastases from gastric cancer. We report a case of 8-year survival achieved by radiotherapy of the metastatic abdominal LNs and local resection of the abdominal wall metastases from tubular adenocarcinoma of the stomach.…”

Section: Discussionmentioning

confidence: 99%

Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

et al. 2018

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We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

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Long-term survival after pulmonary resections for multiple metastases from gastric cancer: A case report

Cited by 5 publications

References 10 publications

Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer

Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer

Prognostic Value of the Site of Distant Metastasis and Surgical Interventions in Metastatic Gastric Cancer: A Population-Based Study

Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

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