Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: Greco, Stephanie H.; Chao, Joshua C.; Heath, Nicole G.; Lin, Yong; Gall, Victor A.; Grandhi, Miral S.; Kennedy, Timothy J.; Carpizo, Darren R.; Alexander, H. Richard; Langan, Russell C.; August, David A.
• Is Part Of: American surgeon. Volume 88:Issue 11(2022)
• Page Start: 2637
• Page End: 2643
• Publication Date: 2022-11
• Subjects: metastasectomy -- gastric cancer; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/00031348221086800
• Languages: English
• ISSNs: 0003-1348

Abstract

Background: The 5-year overall survival (OS) rate for patients with metastatic gastric cancer (mGC) is 5.3%. Surgery for mGC is controversial. Methods: We identified all mGC patients who received chemotherapy using the National Cancer Database (2004-2015). Patients were grouped according to surgery of: (1) the primary site (PS) only, (2) primary and distant sites (PDS), (3) distant site only (DS), or (4) no surgery (NS). A propensity score adjustment and multivariate regression was used to compare OS. Results: Overall, 18, 772 patients met the inclusion criteria: (1) PS (n = 962, 5.1%), (2) PDS (n = 380, 2.1%), (3) DS (n = 984, 5.2%), and 16, 446 NS (87.6%). Surgery was associated with improved OS in the PS and PDS groups (hazard ratios: .489 (95% CI: .376-.636); .583 (95% CI: .420-.811), P < .001) (median OS 15.8 and 15.9 months vs 8.6 for NS patients, respectively). Conclusions: Gastrectomy with or without metastasectomy is associated with improved survival in stage IV gastric cancer patients receiving chemotherapy. This warrants further prospective studies.