Zhao Lin, Li Jiarui, Bai Chunmei, Nie Yongdu, Lin Guole
Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2019 Nov 1;9:1155. doi: 10.3389/fonc.2019.01155. eCollection 2019.
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. 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. 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, < 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, = 0.014). Multi-modality treatments offer a survival benefit for patients with metastatic GC. Future prospective studies are needed to confirm the result.
转移性胃癌（GC）患者预后较差。本研究旨在探讨多模式治疗对转移性GC患者的疗效。我们回顾性纳入了267例接受全身化疗的IV期胃癌患者：114例接受了多模式治疗，153例仅接受了全身化疗。通过对数秩检验比较两组的生存率，使用单因素和多因素分析研究独立预后因素。接受多模式治疗的转移性GC患者的中位生存期显著长于仅接受全身化疗的患者（18.4个月对11.4个月，<0.001）。多因素分析确定肿瘤组织学分化、CA19-9水平、既往根治性切除、姑息性胃切除术和转移灶切除术为总生存的独立预后因素。在多模式治疗组中，接受姑息性胃切除术或转移灶切除术的患者比仅接受腹腔内化疗或放疗的患者生存期更长（21.6个月对15.2个月，=0.014）。多模式治疗为转移性GC患者带来生存获益。未来需要进行前瞻性研究以证实该结果。
