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- Title
Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis.
- Authors
Greco, Stephanie H.; Chao, Joshua C.; Heath, Nicole G.; Lin, Yong; Gall, Victor A.; Grandhi, Miral S.; Kennedy, Timothy J.; Carpizo, Darren R.; Alexander, H. Richard; Langan, Russell C.; August, David A.
- Abstract
<bold>Background: </bold>The 5-year overall survival (OS) rate for patients with metastatic gastric cancer (mGC) is 5.3%. Surgery for mGC is controversial.<bold>Methods: </bold>We identified all mGC patients who received chemotherapy using the National Cancer Database (2004-2015). Patients were grouped according to surgery of: (1) the primary site (PS) only, (2) primary and distant sites (PDS), (3) distant site only (DS), or (4) no surgery (NS). A propensity score adjustment and multivariate regression was used to compare OS.<bold>Results: </bold>Overall, 18,772 patients met the inclusion criteria: (1) PS (n = 962, 5.1%), (2) PDS (n = 380, 2.1%), (3) DS (n = 984, 5.2%), and 16,446 NS (87.6%). Surgery was associated with improved OS in the PS and PDS groups (hazard ratios: .489 (95% CI: .376-.636); .583 (95% CI: .420-.811), P < .001) (median OS 15.8 and 15.9 months vs 8.6 for NS patients, respectively).<bold>Conclusions: </bold>Gastrectomy with or without metastasectomy is associated with improved survival in stage IV gastric cancer patients receiving chemotherapy. This warrants further prospective studies.
- Subjects
SPLEEN tumors; STOMACH tumors; RETROSPECTIVE studies; PROGNOSIS; GASTRECTOMY; TUMOR classification; OVERALL survival; PROPORTIONAL hazards models; LONGITUDINAL method
- Publication
American Surgeon, 2022, Vol 88, Issue 11, p2637
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/00031348221086800