Survival benefit of conversion surgery after intensive chemotherapy for unresectable metastatic gastric cancer : a propensity score-matching analysis
PURPOSE: The clinical benefit of conversion surgery (CS) for unresectable gastric cancer (GC), whereby unresectable GC responds to chemotherapy and subsequently receives curative-intent surgery, remains unclear. Here, we aimed to clarify the clinical value of CS.
METHODS: In this retrospective cohort study, we analyzed 175 unresectable GC, who received triple combined chemotherapy between 2004 and 2019. We divided patients into two groups: those who underwent CS and those receiving chemotherapy only (CS and C groups, respectively). Propensity score matching was used to minimize confounding bias.
RESULTS: Of 175 cases, 61 (34.9%) underwent CS. R0 resection was obtained in 85.2%. After matching, 44 pairs were selected; there were no significant differences in baseline covariants. Group CS had a significantly better median overall survival (OS) (18.8 vs. 46.0 months, p < 0.001), and prolonged progression-free survival (7.4 vs. 25.8 months, p < 0.001). Subgroup analysis of OS showed a favorable trend for CS for almost all subgroups. Multivariate analysis revealed that good ECOG performance status and CS were associated with a longer OS.
CONCLUSION: The survival benefit of CS was consistently demonstrated in the univariate and multivariate analysis, even in the matched cohort. Additional large-scale trials are needed for further validation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:147 |
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| Enthalten in: |
Journal of cancer research and clinical oncology - 147(2021), 8 vom: 03. Aug., Seite 2385-2396 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ohnuma, Hiroyuki [VerfasserIn] |
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| Links: |
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| Themen: |
Chemotherapy |
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| Anmerkungen: |
Date Completed 09.07.2021 Date Revised 09.07.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00432-021-03516-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320948854 |
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| 100 | 1 | |a Ohnuma, Hiroyuki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Survival benefit of conversion surgery after intensive chemotherapy for unresectable metastatic gastric cancer |b a propensity score-matching analysis |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 09.07.2021 | ||
| 500 | |a Date Revised 09.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: The clinical benefit of conversion surgery (CS) for unresectable gastric cancer (GC), whereby unresectable GC responds to chemotherapy and subsequently receives curative-intent surgery, remains unclear. Here, we aimed to clarify the clinical value of CS | ||
| 520 | |a METHODS: In this retrospective cohort study, we analyzed 175 unresectable GC, who received triple combined chemotherapy between 2004 and 2019. We divided patients into two groups: those who underwent CS and those receiving chemotherapy only (CS and C groups, respectively). Propensity score matching was used to minimize confounding bias | ||
| 520 | |a RESULTS: Of 175 cases, 61 (34.9%) underwent CS. R0 resection was obtained in 85.2%. After matching, 44 pairs were selected; there were no significant differences in baseline covariants. Group CS had a significantly better median overall survival (OS) (18.8 vs. 46.0 months, p < 0.001), and prolonged progression-free survival (7.4 vs. 25.8 months, p < 0.001). Subgroup analysis of OS showed a favorable trend for CS for almost all subgroups. Multivariate analysis revealed that good ECOG performance status and CS were associated with a longer OS | ||
| 520 | |a CONCLUSION: The survival benefit of CS was consistently demonstrated in the univariate and multivariate analysis, even in the matched cohort. Additional large-scale trials are needed for further validation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chemotherapy | |
| 650 | 4 | |a Conversion surgery | |
| 650 | 4 | |a Conversion therapy | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Propensity score | |
| 700 | 1 | |a Sato, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Onoyama, Naoki |e verfasserin |4 aut | |
| 700 | 1 | |a Hamaguchi, Kota |e verfasserin |4 aut | |
| 700 | 1 | |a Hayasaka, Naotaka |e verfasserin |4 aut | |
| 700 | 1 | |a Sato, Masanori |e verfasserin |4 aut | |
| 700 | 1 | |a Murase, Kazuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Takada, Kohichi |e verfasserin |4 aut | |
| 700 | 1 | |a Miyanishi, Koji |e verfasserin |4 aut | |
| 700 | 1 | |a Murakami, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ito, Tatsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Nobuoka, Takayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Takemasa, Ichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kato, Junji |e verfasserin |4 aut | |
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