Abstract
This study aimed to examine the efficacy of surgical intervention after chemotherapy for stage IV gastric cancer and the predictors of survival after surgical intervention. Forty-three gastric cancer patients who had only one type of incurable factor (e.g., para-aortic lymph node metastasis) and had undergone initial chemotherapy, underwent chemotherapy alone (CX group; n=25), palliative gastrectomy (PS group; n=8), and conversion surgery (CS group; n=10). Their therapeutic outcomes were compared. The CS group had significantly higher 2-year overall survival rates (80%) than the CX group (25%), whose prognosis was similar to that of the PS group (23%; p<0.001). Pathological complete response of para-aortic lymph node or peritoneal metastases was an independent predictor of survival after surgery, as was >6 months of chemotherapy. CS may improve the prognosis of patients with stage IV gastric cancer in whom chemotherapy can achieve pathological disappearance of the metastatic lesions.
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