Huang Ruo-Yi, Kou Hao-Wei, Le Puo-Hsien, Kuo Chia-Jung, Chen Tsung-Hsing, Wang Shang-Yu, Chen Jen-Shi, Yeh Ta-Sen, Hsu Jun-Te
Department of General Surgery, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.
Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.
J Pers Med. 2022 Apr 1;12(4):555. doi: 10.3390/jpm12040555.
The survival benefits of conversion surgery in patients with metastatic gastric cancer (mGC) remain unclear. Thus, this study aimed to determine the outcomes of conversion surgery compared to in-front surgery plus palliative chemotherapy (PCT) or in-front surgery alone for mGC. We recruited 182 consecutive patients with mGC who underwent gastrectomy, including conversion surgery, in-front surgery plus PCT, and in-front surgery alone at Linkou Chang Gung Memorial Hospital from 2011 to 2019. The tumor was staged according to the 8th edition of the American Joint Committee on Cancer. Patient demographics and clinicopathological factors were assessed. Overall survival (OS) was evaluated using the Kaplan−Meier curve and compared among groups. Conversion surgery showed a significantly longer median OS than in-front surgery plus PCT or in-front surgery alone (23.4 vs. 13.7 vs. 5.6 months; log rank p < 0.0001). The median OS of patients with downstaging (pathological stage I−III) was longer than that of patients without downstaging (stage IV) (30.9 vs. 18.0 months; p = 0.016). Our study shows that conversion surgery is associated with survival benefits compared to in-front surgery plus PCT or in-front surgery alone in patients with mGC. Patients who underwent conversion surgery with downstaging had a better prognosis than those without downstaging.
转移性胃癌（mGC）患者行转化手术的生存获益尚不清楚。因此，本研究旨在确定与先行手术加姑息化疗（PCT）或单纯先行手术相比，mGC患者行转化手术的结局。我们招募了182例连续接受胃切除术的mGC患者，包括转化手术、先行手术加PCT以及2011年至2019年在林口长庚纪念医院单纯接受先行手术的患者。根据美国癌症联合委员会第8版对肿瘤进行分期。评估患者的人口统计学和临床病理因素。使用Kaplan-Meier曲线评估总生存期（OS）并在组间进行比较。转化手术的中位OS明显长于先行手术加PCT或单纯先行手术（23.4个月对13.7个月对5.6个月；对数秩检验p<0.0001）。降期（病理分期I-III期）患者的中位OS长于未降期（IV期）患者（30.9个月对18.0个月；p=0.016）。我们的研究表明，与mGC患者的先行手术加PCT或单纯先行手术相比，转化手术具有生存获益。接受转化手术且降期的患者比未降期的患者预后更好。
