Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database

Abstract In the West, more than one third of newly diagnosed subjects show metastatic disease in gastric cancer (mGC) with few care options available. Gastrectomy has recently become a subject of debate, with some evidence showing advantages in survival beyond the sole purpose of treatment tumor-rel...

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Autores principales:	Jacopo Desiderio, Andrea Sagnotta, Irene Terrenato, Bruno Annibale, Stefano Trastulli, Federico Tozzi, Vito D’Andrea, Sergio Bracarda, Eleonora Garofoli, Yuman Fong, Yanghee Woo, Amilcare Parisi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/97c8124831574bfba37e1ccbf4553113
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spelling	oai:doaj.org-article:97c8124831574bfba37e1ccbf45531132021-12-02T14:23:04ZGastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database10.1038/s41598-021-86352-62045-2322https://doaj.org/article/97c8124831574bfba37e1ccbf45531132021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86352-6https://doaj.org/toc/2045-2322Abstract In the West, more than one third of newly diagnosed subjects show metastatic disease in gastric cancer (mGC) with few care options available. Gastrectomy has recently become a subject of debate, with some evidence showing advantages in survival beyond the sole purpose of treatment tumor-related complications. We investigated the survival benefit of different strategies in mGC patients, focusing on the role and timing of gastrectomy. Data were extracted from the SEER database. Groups were determined according to whether patients received gastrectomy, chemotherapy, supportive care. Patients receiving a multimodality treatment were further divided according to timing of surgery, whether performed before (primary gastrectomy, PG) or after chemotherapy (secondary gastrectomy, SG). 16,596 patients were included. Median OS was significantly higher (p < 0.001) in the SG (15 months) than in the PG (13 months), gastrectomy alone (6 months), and chemotherapy (7 months) groups. In the multivariate analysis, SG showed better OS (HR = 0.22, 95%CI = 0.18–0.26, p < 0.001) than PG (HR = 0.25, 95%CI = 0.23–0.28, p < 0.001), gastrectomy (HR = 0.40, 95%CI = 0.36–0.44, p < 0.001), and chemotherapy (HR = 0.42, 95%CI = 0.4–0.44, p < 0.001). The survival benefits persisted even after the PSM analysis. This study shows survival advantages of gastrectomy as multimodality strategy after chemotherapy. In selected patients, SG can be proposed to improve the management of stage IV disease.Jacopo DesiderioAndrea SagnottaIrene TerrenatoBruno AnnibaleStefano TrastulliFederico TozziVito D’AndreaSergio BracardaEleonora GarofoliYuman FongYanghee WooAmilcare ParisiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-16 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jacopo Desiderio Andrea Sagnotta Irene Terrenato Bruno Annibale Stefano Trastulli Federico Tozzi Vito D’Andrea Sergio Bracarda Eleonora Garofoli Yuman Fong Yanghee Woo Amilcare Parisi Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
description	Abstract In the West, more than one third of newly diagnosed subjects show metastatic disease in gastric cancer (mGC) with few care options available. Gastrectomy has recently become a subject of debate, with some evidence showing advantages in survival beyond the sole purpose of treatment tumor-related complications. We investigated the survival benefit of different strategies in mGC patients, focusing on the role and timing of gastrectomy. Data were extracted from the SEER database. Groups were determined according to whether patients received gastrectomy, chemotherapy, supportive care. Patients receiving a multimodality treatment were further divided according to timing of surgery, whether performed before (primary gastrectomy, PG) or after chemotherapy (secondary gastrectomy, SG). 16,596 patients were included. Median OS was significantly higher (p < 0.001) in the SG (15 months) than in the PG (13 months), gastrectomy alone (6 months), and chemotherapy (7 months) groups. In the multivariate analysis, SG showed better OS (HR = 0.22, 95%CI = 0.18–0.26, p < 0.001) than PG (HR = 0.25, 95%CI = 0.23–0.28, p < 0.001), gastrectomy (HR = 0.40, 95%CI = 0.36–0.44, p < 0.001), and chemotherapy (HR = 0.42, 95%CI = 0.4–0.44, p < 0.001). The survival benefits persisted even after the PSM analysis. This study shows survival advantages of gastrectomy as multimodality strategy after chemotherapy. In selected patients, SG can be proposed to improve the management of stage IV disease.
format	article
author	Jacopo Desiderio Andrea Sagnotta Irene Terrenato Bruno Annibale Stefano Trastulli Federico Tozzi Vito D’Andrea Sergio Bracarda Eleonora Garofoli Yuman Fong Yanghee Woo Amilcare Parisi
author_facet	Jacopo Desiderio Andrea Sagnotta Irene Terrenato Bruno Annibale Stefano Trastulli Federico Tozzi Vito D’Andrea Sergio Bracarda Eleonora Garofoli Yuman Fong Yanghee Woo Amilcare Parisi
author_sort	Jacopo Desiderio
title	Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
title_short	Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
title_full	Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
title_fullStr	Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
title_full_unstemmed	Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database
title_sort	gastrectomy for stage iv gastric cancer: a comparison of different treatment strategies from the seer database
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/97c8124831574bfba37e1ccbf4553113
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Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database

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