Selecting patients for gastrectomy in metastatic esophago-gastric cancer: clinics and pathology are not enough. (October 2017)

• Record Type: Journal Article
• Authors: Fornaro, Lorenzo; Fanotto, Valentina; Musettini, Gianna; Uccello, Mario; Rimassa, Lorenza; Vivaldi, Caterina; Fontanella, Caterina; Leone, Francesco; Giampieri, Riccardo; Rosati, Gerardo; Lencioni, Monica; Santini, Daniele; Di Donato, Samantha; Tomasello, Gianluca; Brunetti, Oronzo; Pietrantonio, Filippo; Bergamo, Francesca; Scartozzi, Mario; Avallone, Antonio; Lutrino, Stefania Eufemia; Melisi, Davide; Antonuzzo, Lorenzo; Pellegrino, Antonio; Gerratana, Lorenzo; Cordio, Stefano; Vasile, Enrico; Aprile, Giuseppe
• Is Part Of: Future oncology. Volume 13:Number 25(2017)
• Page Start: 2265
• Page End: 2275
• Publication Date: 2017-10
• Subjects: chemotherapy -- metastatic gastric cancer -- palliative gastrectomy; Oncology -- Periodicals; 616.99405
• DOI: 10.2217/fon-2017-0246
• Languages: English
• ISSNs: 1479-6694

Abstract

Aim: To evaluate the impact on overall survival (OS) of gastrectomy in asymptomatic metastatic esophago-gastric cancer.Patients & methods: Five hundred and thirteen patients were included. The role of surgery and other clinico-pathological factors was evaluated by univariate and Cox regression analyses. OS was the primary end point.Results: Multivariate analysis confirmed that gastrectomy was a predictor of longer OS (p < 0.001), as well as preserved performance status and benefit from first-line chemotherapy. None of the investigated clinico-pathological variables identified preferable candidates for surgery (all p > 0.05).Conclusion: Palliative gastrectomy might play a role in asymptomatic metastatic esophago-gastric cancer patients with good performance status who received benefit from first-line chemotherapy. Future prospective trials integrating tumor biology among inclusion criteria may help defining the optimal candidates.