Treatment modalities and oncological outcomes in a cohort of patients with advanced gastric cancer in Mexico.

Abstract

e15590 Background: Gastric cancer (GC) represents the third leading cause of cancer related death in Mexico. Treatment modalities and outcomes have been infrequently reported in our population. Methods: we retrospectively reviewed medical records from all consecutive patients with histologically confirmed metastatic GC treated from January 2005 to December 2015 at our institution. EG junction primaries were excluded. Overall survival (OS) was estimated by Kaplan Meier method from histological diagnosis to dead or last date of follow up and compared by Log-rank test. P value < 0.05 was considered significant. Results: 172 patients were included: 53.5% women, median age 55 years. Lauren’s classification: diffuse 57%, intestinal 20%, 3% mixed and 20% non-specified. Signet ring cells were found in 66% of cases. 37% have T4 tumors. Treatment modalities: 22% none treatment, 12% palliative care, 48% systemic chemotherapy at any time of disease course, 29% initial palliative surgery (derivative o gastrectomy), gastrectomy at any time in 14% (n 24). An R0 resection was achieved in 6/24 of patients. For those patients who received systemic chemotherapy (n 83) objective response rate was 34% and disease control rate 70%. Median OS according to treatment is shown in table. Only 35% of patients received second line chemotherapy and 7% a third line. Conclusions: patients with advanced GC have a dismal prognosis in our center. A third of patients present with terminal disease and are ineligible for oncological treatment. Chemotherapy can be offered to less than a half of patients. Palliative gastrectomy is offered to 12%. Multimodal therapy is associated with the best survival but could be offered to less than 10% of patients. [Table: see text]