Surgical Outcome and Long-Term Survival of Conversion Surgery for Advanced Gastric Cancer
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ORIGINAL ARTICLE – GASTROINTESTINAL ONCOLOGY
Surgical Outcome and Long-Term Survival of Conversion Surgery for Advanced Gastric Cancer Guo-Ming Chen, MD1, Shu-Qiang Yuan, MD, PhD1, Run-Cong Nie, MD, PhD1, Tian-Qi Luo, MD1, Kai-Ming Jiang, MD1, Cheng-Cai Liang, MD, PhD1, Yuan-Fang Li, MD, PhD1, De-Yao Zhang, MD1, Jie-Hai Yu, MD3, Fan Hou, MA4, Yun Wang, MD, PhD2, and Ying-Bo Chen, MD1 1
State Key Laboratory of Oncology in South China, Department of Gastric Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; 2State Key Laboratory of Oncology in South China, Department of Hematological Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; 3State Key Laboratory of Oncology in South China, Department of Gynecology, Sun Yat-sen University Cancer Center, Guangzhou, China; 4Penn Graduate School of Education, University of Pennsylvania, Philadelphia, PA
ABSTRACT Background. The present study aims to report the surgical outcome and long-term survival of conversion surgery and clarify its role in advanced gastric cancer. Patients and Methods. A total of 95 primary advanced gastric adenocarcinoma patients who underwent systemic chemotherapy and conversion surgery were reviewed retrospectively. The survival of conversion surgery was analyzed by Cox regression and the Kaplan–Meier method. Surgical outcomes were analyzed according to the Clavien–Dindo classification. Results. The median survival time (MST) of the 95 patients was 26.8 months, and the postoperative MST was
Guo-Ming Chen, Shu-Qiang Yuan, Run-Cong Nie, Tian-Qi Luo have contributed equally to this study. Yun Wang, Ying-Bo Chen are co-senior authors.
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-08559-7) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 9 October 2019 Y. Wang, MD, PhD e-mail: [email protected] Y.-B. Chen, MD e-mail: [email protected]
19.3 months. The MSTs of the patients in categories 1, 2, 3, and 4 were 28.8, 25.5, 43.6, and 11.3 months, respectively. The MSTs of the patients who underwent R0 resection (47 cases) and R1/2 resection (48 cases) were 49.3 months and 21.9 months, respectively. The MST of patients treated with total gastrectomy was shorter (21.9 months) than that of patients who underwent proximal (55.0 months) or distal (46.3 months) gastrectomy. Patients who received more than 6 cycles of induction chemotherapy had a longer MST than patients who received 3–5 cycles or 1–2 cycles (MST: 55.0 months versus 21.1 months versus 21.7 months). The incident postoperative complications and postoperative mortality rates were 10.5% and 1.1%, respectively. Conclusions. Advanced gastric cancer patients may obtain a survival benefit from conversion surgery, except category 4. Performing a sufficient number of cycles of induction chemotherapy (usually C 6 cycles) is recommended. S
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