scholarly journals REG Iα is a biomarker for predicting response to chemotherapy with S-1 plus cisplatin in patients with unresectable stage IV gastric cancer

2013 ◽  
Vol 108 (2) ◽  
pp. 395-401 ◽  
Author(s):  
A Sekikawa ◽  
H Fukui ◽  
X Zhang ◽  
T Maruo ◽  
T Tsumura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Unresectable Stage ◽  
Response To Chemotherapy ◽  
Reg Iα

The prognostic factor and the optimal timing of conversion surgery in unresectable stage IV gastric cancer: A retrospective analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 78-78
Author(s):  
Tamotsu Sagawa ◽  
Yutaka Okagawa ◽  
Fumito Tamura ◽  
Tsuyoshi Hayashi ◽  
Koshi Fujikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Residual Tumor ◽  
Optimal Timing ◽  
Conversion Surgery ◽  
Stage Iv Gastric Cancer ◽  
Metastatic Lesions ◽  
Unresectable Stage

78 Background: Conversion surgery could be an option for unresectable stage IV gastric cancer when distant metastasis (M1) is disappeared by chemotherapy. However, the indication and the optimal timing of conversion surgery in stage IV gastric cancer remain unclear, even if metastatic lesions disappear with chemotherapy. Guideline of National Comprehensive Cancer Network also shows no principle after down-staging. Methods: This retrospective study examined 34 gastric cancer patients who underwent curative conversion surgery at our institute between 2005 and 2014. Clinicopathologic characteristics and patient outcomes were analyzed, with particular focus on the potential to select patients who might benefit from surgical resection. Results: The number of M1 factors was one in 31 patients and two in 3, including metastases to non-regional lymph node in 21, peritoneum in 8, liver in 5, and lung in 3. The regimen of chemotherapy was Docetaxel/CDDP/S-1 in 23 patients, Docetaxel/CDDP/S-1+Trastuzmab in 6, S-1/CDDP in 2, Docetaxel/S-1 in 1, CPT/CDDP in 1, and S-1 monotherapy in 1. The median duration from initiation of chemotherapy to the operation was 114 days (range 37-653 days). Total gastrectomy was performed in 27 patients and distal gastrectomy was performed in 7 patients. Complete resection with no residual tumor (R0) was achieved in 23 of 34 patients, microscopic residual tumor status (R1) in 10, and macroscopic residual tumor (R2) in 1. The 3-year overall survival (OS) rate among the patients who underwent conversion therapy was 58.0% with MST of 1190 days. Univariate analysis among the patents with conversion surgery identified intestinal differentiation, pathological response grade≧1b, R0 resection as significant prognostic factors. Patients operated on more than 91 days from initiation of chemotherapy had the 3-year survival rate of 68.2%, compared to 40.0% for patients operated on less than 90 days. Conclusions: Our data demonstrate the increased 3-year survival rate associated with delayed conversion surgery for stage IV gastric cancer. Delayed conversion surgery should be considered for patients, even if metastatic lesions disappear with chemotherapy.

Gastrectomy after chemotherapy: A new paradigm for the treatment of stage IV gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 127-127 ◽  
Author(s):  
Ho Seok Seo ◽  
Cho Hyun Park ◽  
Kyo Young Song ◽  
Yoon Ju Jung
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Supportive Care ◽  
Stage Iv ◽  
Best Supportive Care ◽  
Treatment Modalities ◽  
Care Group ◽  
R0 Resection ◽  
Stage Iv Gastric Cancer ◽  
Response To Chemotherapy

127 Background: Although there are several traditional treatment modalities for stage IV gastric cancer including chemotherapy, radiation therapy, palliative surgery, or best supportive care, survival result is unsatisfactory. Recently, gastrectomy after chemotherapy which is called conversion surgery or adjuvant surgery was introduced. Methods: In total, 419 patients who were diagnosed stage IV gastric cancer from 2010 to 2015 in eight Catholic Medical Center affiliated hospitals were divided into four groups; 212 for chemotherapy only group (G1), 124 for chemotherapy after primary gastrectomy group (G2), 23 for gastrectomy after chemotherapy group (G3), and 60 for best supportive care group (G4). To compensate chemotherapy effects, cases of complete remission, partial response, and stable disease were selectively analyzed. To identify the factors that affected survival rate, the result of surgery and the intent of surgery of the G3 were analyzed. Results: Three-year survival rate of the G3 was significantly higher than that of the G1 (42.8% vs 12.0%, p = 0.001). In case of the patients with a response to chemotherapy, three-year survival rate showed similar result (G3 vs G1, 46.1% vs 18.4%, p = 0.011). In the G3, R0 resection and curative intent of resection showed better three-year survival rate (R0 vs R1 or R2, 61.1% vs 16.2%, p = 0.003, curative vs palliative, 62.3% vs 23.8%, p = 0.031). Conclusions: The present study showed that gastrectomy after chemotherapy might improve the survival rate for the patients with stage IV gastric cancer, especially who could undergo R0 resection.

The Significance of Prophylactic Gastrojejunostomy for Patients with Unresectable Stage IV Gastric Cancer

2009 ◽  
Vol 9 (4) ◽  
pp. 231 ◽  
Author(s):  
Hwan Soo Kim ◽  
Chong Suk Kim ◽  
Jong Han Kim ◽  
Young Jae Mok ◽  
Sung Soo Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Unresectable Stage

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

2016 ◽  
Vol 25 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Kunihiko Izuishi ◽  
Hirohito Mori
Keyword(s):  
Gastric Cancer ◽  
Performance Status ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Palliative Gastrectomy ◽  
Advanced Tumor ◽  
Esophagogastric Cancer ◽  
Previously Treated

Recently, many strategies have been reported for the effective treatment of gastric cancer. However, the strategy for treating stage IV gastric cancer remains controversial. Conducting a prospective phase III study in stage IV cancer patients is difficult because of heterogeneous performance status, age, and degree of cancer metastasis or extension. Due to poor prognosis, the variance in physical status, and severe symptoms, it is important to determine the optimal strategy for treating each individual stage IV patient. In the past decade, many reports have addressed topics related to stage IV gastric cancer: the 7th Union for International Cancer Control (UICC) TNM staging system has altered its stage IV classification; new chemotherapy regimens have been developed through the randomized ECF for advanced and locally advanced esophagogastric cancer (REAL)-II, S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer (SPIRITS), trastuzumab for gastric cancer (ToGA), ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD), and ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW) trials; and the survival efficacy of palliative gastrectomy has been denied by the reductive gastrectomy for advanced tumor in three Asian countries (REGATTA) trial. Current strategies for treating stage IV patients can be roughly divided into the following five categories: palliative gastrectomy, chemotherapy, radiotherapy, gastric stent, or bypass. In this article, we review recent publications and guidelines along with above categories in the light of individual symptoms and prognosis. Abbreviations: APC: argon plasma coagulation; AVAGAST: anti-angiogenic antibody bevacizumab, the avastin in gastric cancer; BSC: best supportive care; CF: cisplatin and fluorouracil; CRP: C-reactive protein; DCF: docetaxel, cisplatin, and 5-FU; FISH: fluorescent in-situ hybridization; GJ: gastrojejunostomy; GPS: Glasgow Prognostic Score; HER: human epidermal growth factor receptor; HR: hazard ratio; NLR: neutrophil-to-lymphocyte ratio; OS: overall survival; PS: performance status; QOL: quality of life; RAINBOW: ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; RCTs: randomized controlled trials; REAL: randomized ECF for advanced and locally advanced esophagogastric cancer; REGARD: ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; REGATTA: reductive gastrectomy for advanced tumor in three Asian countries; SEER: Surveillance Epidemiology and End Results; SEMS: self-expandable metal stents; SPIRITS: S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer; ToGA: trastuzumab for gastric cancer; TTP: time-to-progression; VEGFR: vascular endothelial growth factor receptor.

Conversion surgery of Stage IV gastric cancer with peritoneal dissemination after nivolumab

2021 ◽  
Author(s):  
Yuji Toyota ◽  
Kunio Okamoto ◽  
Norimitsu Tanaka ◽  
Hugh Shunsuke Colvin ◽  
Yuta Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Dissemination ◽  
Stage Iv ◽  
Conversion Surgery ◽  
Stage Iv Gastric Cancer

SPan-1 Is a Useful Prognostic Marker for Patients with Stage IV Gastric Cancer Who Underwent Palliative Gastrectomy: A Retrospective Multivariate Study

2013 ◽  
Vol 37 (7) ◽  
pp. 1681-1687
Author(s):  
Naoshi Kubo ◽  
Masaichi Ohira ◽  
Katsunobu Sakurai ◽  
Takahiro Toyokawa ◽  
Hiroaki Tanaka ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Marker ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Palliative Gastrectomy ◽  
Multivariate Study

Is There a Role for Palliative Gastrectomy in Patients with Stage IV Gastric Cancer?

2005 ◽  
Vol 30 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Reza F. Saidi ◽  
Stephen G. ReMine ◽  
Paul S. Dudrick ◽  
Nader N. Hanna
Keyword(s):  
Gastric Cancer ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer ◽  
Palliative Gastrectomy

scholarly journals COMPLETE REMISSION AFTER COMBINATION CHEMOTHERAPY FOR STAGE IV GASTRIC CANCER WITH PERITONEAL DISSEMINATION AND LIVER METASTASES

2003 ◽  
Vol 11 (1-2) ◽  
pp. 169-181 ◽  
Author(s):  
Masaya Mukai ◽  
Tomoya Hinoki ◽  
Takayuki Tajima ◽  
Hisao Nakasaki ◽  
Shinkichi Sato ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Complete Remission ◽  
Liver Metastases ◽  
Combination Chemotherapy ◽  
Peritoneal Dissemination ◽  
Stage Iv ◽  
Stage Iv Gastric Cancer

scholarly journals Prognostic benefit of conversion surgery for HER2 positive stage IV gastric cancer; a case series study of eleven patients treated with trastuzumab-based chemotherapy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Koichi Hayano ◽  
Hiroki Watanabe ◽  
Takahiro Ryuzaki ◽  
Naoto Sawada ◽  
Gaku Ohira ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Stage Iv ◽  
R0 Resection ◽  
Conversion Surgery ◽  
First Line ◽  
Her2 Positive ◽  
Stage Iv Gastric Cancer ◽  
Gastric Cancer Patients ◽  
First Line Treatment

Abstract Background Since the ToGA trial, trastuzumab-based chemotherapy is the standard treatment for HER2 positive stage IV gastric cancer. However, it is not yet clear whether surgical resection after trastuzumab-based chemotherapy (conversion surgery) can improve survival of HER2 positive stage IV gastric cancer. The purpose of this study is to evaluate the prognostic benefit of conversion surgery in HER2 positive stage IV gastric cancer patients. Case presentation We retrospectively investigated the medical records of the patients with HER2 positive (IHC3(+) or IHC2(+)/FISH(+)) stage IV gastric cancer treated with trastuzumab-based chemotherapy as the first line treatment. Overall survival (OS) was compared between patients with conversion surgery and without. Eleven HER2 positive stage IV gastric cancer patients treated with trastuzumab-based chemotherapy as the first line treatment were evaluated. Response rate was 63.6%, and 6 of 11 patients could receive conversion surgery. R0 resection was achieved in four patients. In Kaplan–Meier analysis, patients who received conversion surgery showed significantly better OS than those without surgery (3-year survival rate, 66.7% vs. 20%, P = 0.03). The median OS of patients who achieved R0 resection is 51.8 months. Conclusions Conversion surgery might have a survival benefit for HER2 positive stage IV gastric cancer patients. If curative surgery is technically possible, conversion surgery could be a treatment option for HER2 positive stage IV gastric cancer.

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