&lt;p&gt;Treatment of Synchronous Liver Metastases from Gastric Cancer: A Single-Center Study&lt;/p&gt;

Yu, Pengfei; Zhang, Yanqiang; Ye, Zeyao; Chen, Xiangliu; Huang, Ling; Du, Ye; Cheng, Xiangdong

doi:10.2147/cmar.s261353

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Furthermore, we included in our study only patients with 1-3 LMGC, and 69% of patients in the SR group had only one liver metastasis. This might explain the better OS rates achieved by liver resection in this study compared to the majority of Western reports, since most meta-analyses and retrospective studies revealed that patients with one or two resected LMGCs had significantly higher long-term outcomes than those with more liver metastases [4,5,28,32]. On the other hand, our long-term outcomes achieved by simultaneous resection of GC and LMGC in patients with three or fewer resectable LMGCs are in line with the recommendations of the Chinese consensus on the diagnosis and treatment of gastric cancer with liver metastases, which recommend, for type I LMGC, either upfront simultaneous resection or preoperative chemotherapy followed by simultaneous resection [19].…”

Section: Discussionmentioning

confidence: 67%

Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

et al. 2022

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Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection.

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Section: Discussionmentioning

confidence: 67%

Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

et al. 2022

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“…In the case of liver metastases from gastric cancer, C-GCLM staging type I and some type II are feasible for comprehensive surgery-centered treatment, and it is noted that resection of the primary site and metastases can increase the overall 5-year survival rate of patients with liver metastases from gastric cancer to more than 20% under strict screening of the patient population ( 17 ). Yu et al ( 18 ) conducted a retrospective analysis of the treatment of 132 patients with concurrent liver metastases. The results showed that R0 resection significantly prolonged survival time (33.6 months vs. 12 months).…”

Section: Introductionmentioning

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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“…Most of the current clinical studies are retrospective cohort studies ( 12 , 13 ), so the current evidence is not sufficient to support a treatment strategy of D2 gastrectomy plus liver radiofrequency plus postoperative chemotherapy for standardized treatment of patients with GCLM. At the same time, there is also a lack of prospective studies on the efficacy of D2 gastrectomy plus liver radiofrequency plus postoperative chemotherapy versus chemotherapy alone for treatment in China.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of D2 Gastrectomy Plus Liver Radiofrequency Combined With Chemotherapy Versus Chemotherapy Alone in the Treatment of Advanced Gastric Cancer With Unresectable Synchronous Liver Metastases: A Multicenter Randomized Controlled Trial Protocol

Wang

Gao

et al. 2022

Front. Oncol.

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BackgroundWhether patients with advanced gastric cancer with unresectable synchronous liver metastases require surgical treatment remains a controversial topic among surgeons. Recently, an open-label multicenter, international RCT study show that compared with chemotherapy alone, gastric resection combined with chemotherapy had no survival advantage for advanced gastric cancer with unresectable synchronous liver metastases. A limitation of this study was that gastrectomy for gastric cancers was restricted to D1 lymphadenectomy and no metastatic lesions were removed. Whether D2 gastrectomy plus liver radiofrequency plus postoperative chemotherapy could provide benefits to these patients is worthy of further confirmation by high-level evidence-based medicine.Methods/DesignThis study will investigate the efficacy of D2 gastrectomy plus liver radiofrequency plus postoperative chemotherapy compared to chemotherapy alone in a prospective, multicenter, randomized controlled trial that will enroll 200 patients who have advanced gastric cancer with unresectable synchronous liver metastases. The patients will be randomly divided into two groups: the test group (D2 gastrectomy plus liver radiofrequency plus postoperative chemotherapy, n=100) and the control group (chemotherapy alone, n=100). The patients’ general information, past medical history, laboratory tests, imaging results, surgery details, and chemotherapy details will be recorded and analysed. The overall survival (OS) will be recorded as primary endpoints. Progression-free survival (PFS) and the total incidence of complications will be recorded as secondary endpoints.DiscussionThis study is to establish a multicentre randomized controlled trial to compare the efficacy of D2 gastrectomy plus liver radiofrequency combined with postoperative chemotherapy versus chemotherapy alone.Trial RegistrationChinese Clinical Trial Registry, Approved No. of ethics committee:ChiECRCT20200331. Registered on 15 November 2020. Registration number:ChiCTR2000039964. The study has received full ethical and institutional approval.Advantages and Limitations of this StudyThis is the first clinical trial that will provide evidence on the efficacy of D2 gastrectomy plus liver radiofrequency combined with chemotherapy versus chemotherapy alone for the treatment of advanced gastric cancer with unresectable synchronous liver metastases. A prospective RCT with 200 patients who have advanced gastric cancer with unresectable synchronous liver metastases.Clinical Trial Registration[https://www.chictr.org.cn/], identifier ChiCTR2000039964.

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<p>Treatment of Synchronous Liver Metastases from Gastric Cancer: A Single-Center Study</p>

Cited by 12 publications

References 20 publications

Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

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

Comparison of the Efficacy of D2 Gastrectomy Plus Liver Radiofrequency Combined With Chemotherapy Versus Chemotherapy Alone in the Treatment of Advanced Gastric Cancer With Unresectable Synchronous Liver Metastases: A Multicenter Randomized Controlled Trial Protocol

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