P1-10-6 - Survival Analysis of Unresectable Gastric Cancer Patients Judged Resectable by Initial Ct

Abstract

Background: Some cases of initially resectable advanced gastric cancer (AGC) are found unresectable during operation due to metastasis or organ invasion. In those cases S1 plus cisplatin (SP) is the standard chemotherapy in Japan. However the clinical outcome remains unknown precisely.Patients and methods: To clarify the clinical feature and outcome of patients with AGC judged resectable by initial CT (CT resectable group) treated with chemotherapy, we retrospectively compared CT resectable group and CT unresectable group (patients with AGC judged unresectable by initial CT) who received SP as the first-line chemotherapy in Cancer Institute Hospital of JFCR between 2007 and 2011.Results: In the period there were 687 patients with AGC who received systemic chemotherapy and 223 (CT resectable group 22 and CT unresectable group 201) patients received SP as first-line chemotherapy. CT resectable group was more likely to have prior gastrectomy (68.2% vs. 30.8%; P < 0.001) and linitis plastica gastric cancer (54.5% vs. 25.4%; P = 0.001). CT resectable group was less likely to have elevated CEA (9.1% vs. 38.3%; P = 0.004), and elevated ALP (9.1% vs. 29.4%; P = 0.040). Median overall survival of CT resectable group was significantly longer than that of CT unresectable group (777 days vs. 412 days; P = 0.001). Multivariate analysis showed that CT resectable group was not associated with overall survival (P = 0.463). Median time to treatment failure of CT resectable group was significantly longer than that of CT unresectable group (524 days vs. 178 days; P < 0.001).Conclusion: In stage4 gastric cancer patients, significant benefit of prognosis were observed in the patients judged resectable by initial CT than others received SP.