Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis

Stephanie H. Greco; Joshua C. Chao; Nicole G. Heath; Yong Lin; Victor A. Gall; Miral S. Grandhi; Timothy J. Kennedy; Darren R. Carpizo; H. Richard Alexander; Russell C. Langan; David A. August

doi:10.1177/00031348221086800

Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis

Stephanie H. Greco, Joshua C. Chao, Nicole G. Heath, Yong Lin, Victor A. Gall, Miral S. Grandhi, Timothy J. Kennedy, Darren R. Carpizo, H. Richard Alexander, Russell C. Langan, David A. August

Surgery

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

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.

Original language	English
Pages (from-to)	2637-2643
Number of pages	7
Journal	American Surgeon
Volume	88
Issue number	11
DOIs	https://doi.org/10.1177/00031348221086800
State	Published - Nov 2022

Keywords

gastric cancer
metastasectomy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/00031348221086800

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Greco, S. H., Chao, J. C., Heath, N. G., Lin, Y., Gall, V. A., Grandhi, M. S., Kennedy, T. J., Carpizo, D. R., Alexander, H. R., Langan, R. C., & August, D. A. (2022). Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis. American Surgeon, 88(11), 2637-2643. https://doi.org/10.1177/00031348221086800

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title = "Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis",

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.",

keywords = "gastric cancer, metastasectomy",

author = "Greco, {Stephanie H.} and Chao, {Joshua C.} and Heath, {Nicole G.} and Yong Lin and Gall, {Victor A.} and Grandhi, {Miral S.} and Kennedy, {Timothy J.} and Carpizo, {Darren R.} and Alexander, {H. Richard} and Langan, {Russell C.} and August, {David A.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2022.",

year = "2022",

month = nov,

doi = "10.1177/00031348221086800",

language = "English",

volume = "88",

pages = "2637--2643",

journal = "American Surgeon",

issn = "0003-1348",

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T1 - Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer

T2 - A National Cancer Database Analysis

AU - Greco, Stephanie H.

AU - Chao, Joshua C.

AU - Heath, Nicole G.

AU - Lin, Yong

AU - Gall, Victor A.

AU - Grandhi, Miral S.

AU - Kennedy, Timothy J.

AU - Carpizo, Darren R.

AU - Alexander, H. Richard

AU - Langan, Russell C.

AU - August, David A.

PY - 2022/11

Y1 - 2022/11

N2 - 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.

AB - 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.

KW - gastric cancer

KW - metastasectomy

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DO - 10.1177/00031348221086800

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SP - 2637

EP - 2643

JO - American Surgeon

JF - American Surgeon

IS - 11

ER -

Surgery is Associated With Improved Overall Survival in Patients With Metastatic Gastric Cancer: A National Cancer Database Analysis

Abstract

Keywords

UN SDGs

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