Abstract
Introduction: People with metastatic gastric cancer (GC) have a poor prognosis. The study aims to investigate the efficacy of multi-modality treatment for patients with metastatic GC.Methods: We retrospectively identified 267 patients with stage IV gastric cancer who were treated with systemic chemotherapy: 114 received multi-modality treatments, 153 received systematic chemotherapy alone. The survival of these two groups was compared by log rank test, the independent prognostic factors were investigated using univariate and multivariate analyses.Results: The median survival of metastatic GC patients who received multi-modality treatment was significantly longer than those who received systematic chemotherapy alone (18.4 vs. 11.4 months, P < 0.001). Multivariate analysis identified tumor histologic differentiation, CA19–9 level, previous curative resection, palliative gastrectomy, and metastasectomy as independent prognostic factors for overall survival. In the multimodality treatment group, patients who received palliative gastrectomy or metastasectomy had a longer survival than those who only received intraperitoneal chemotherapy or radiotherapy (21.6 vs. 15.2 months, P = 0.014).Conclusion: Multi-modality treatments offer a survival benefit for patients with metastatic GC. Future prospective studies are needed to confirm the result.
Highlights
People with metastatic gastric cancer (GC) have a poor prognosis
The multi-modality treatment group was defined as patients who received both systematic chemotherapy and other modality treatments including palliative gastrectomy and metastasectomy, intraperitoneal chemotherapy, radiotherapy, radiofrequency ablation, and transarterial chemoembolization (TACE)
The results demonstrated that factors such as differentiation, CA19–9 level, previous curative surgery, palliative gastrectomy, metastasectomy, and radiotherapy were correlated with overall survival (OS) (Table 4)
Summary
People with metastatic gastric cancer (GC) have a poor prognosis. Almost one million new cases of GC were diagnosed each year, and about 50% of them occurred in Eastern Asia (mainly in China) [2]. An improvement of 5-years survival for GC was observed in the past 10 years, the prognosis of Chinese GC patients was still poor. Compared with a very high survival of GC in Korea (68·9%) and Japan (60·3%), the age-standardized 5-years relative survival was only 35.1% in China because most patients have inoperable disease at the time of initial presentation [3,4,5]. People with metastatic GC have a poor prognosis with a median survival time of around 4 months in the absence
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