Predictive factors for long-term survival after conversion surgery for unresectable gastric cancer: A retrospective analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 205-205
Author(s):  
Tamotsu Sagawa ◽  
Kyoko Hamaguchi ◽  
Akira Sakurada ◽  
Fumito Tamura ◽  
Tsuyoshi Hayashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Residual Tumor ◽  
R0 Resection ◽  
Conversion Surgery ◽  
Tumor Depth ◽  
Term Survival ◽  
Long Term Survival ◽  
Line Therapy ◽  
Unresectable Gastric Cancer

205 Background: Chemotherapy occasionally converts an initially unresectable gastric cancer to a resectable cancer. However, the association between clinical factors and long-term prognosis after conversion surgery for unresectable gastric cancer has not been investigated. Methods: We retrospective reviewed 36 gastric cancer patients who underwent conversion surgery at our institute between 2005 and 2015. Clinicopathologic characteristics and patient outcomes were analyzed, with particular focus on the potential to predict long-term survival. Results: The number of incurable factors was one in 31 patients and two in 5, including metastases to non-regional lymph node in 22, peritoneum in 10, liver in 6, and lung in 3. The regimen of chemotherapy was Docetaxel/CDDP/S-1 in 23 patients, Docetaxel/CDDP/S-1+Trastuzmab in 7, S-1/CDDP in 2, Docetaxel/S-1 in 1, CPT/CDDP in 1, and S-1 monotherapy in 1. Complete resection with no residual tumor (R0) was achieved in 25 of 36 patients, microscopic residual tumor status (R1) in 10, and macroscopic residual tumor (R2) in 1. The 3-year overall survival (OS) rate among the 36 patients who underwent conversion surgery was 60.3 % (median survival time, 1200 days). The 3-year OS rate among patients who underwent R0 resection was 70.8 % (median survival time, 1503 days). Patients who underwent R0 resection had significantly longer OS times than those who underwent R1 and R2 resection ( p=0.0124). We selected 16 variables in addition to residual tumor for Kaplan–Meier analysis. According to the log rank test, the following four variables were significantly associated with a better OS: clinical response to 1st line therapy (CR or PR vs. SD or PD)( p=0.0283), pathological response grade (1b-3 vs. 0-1a) ( p=0.0304), pathological tumor depth (CR or T1~T3 vs. T4) ( p=0.0261), and pathological nodal stage (N0〜2 vs. N3) ( p=0.0086). Conclusions: Our data indicates that clinical response to 1st line therapy in preoperative characteristics, R0 resection, pathological response grade, pathological tumor depth, pathological nodal stage in postoperative characteristics are predictive factors that can be expected to long-term survival.

scholarly journals Impact on long-term survival of the number of lymph nodes resected in patients with pT1N0 gastric cancer after R0 resection

Medicine ◽  
2016 ◽  
Vol 95 (31) ◽  
pp. e4420 ◽  
Author(s):  
Jiuda Zhao ◽  
Feng Du ◽  
Yu Zhang ◽  
Jie Kan ◽  
Li Dong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
R0 Resection ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Long-term survival achieved by repeated administration of ramucirumab after drug holidays due to proteinuria in recurrent gastric cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoyuki Uehata ◽  
Keita Kouzu ◽  
Hironori Tsujimoto ◽  
Hidekazu Sugasawa ◽  
Kotaro Wakamatsu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Disease Progression ◽  
Repeated Administration ◽  
Term Survival ◽  
Case Presentation ◽  
Long Term Survival ◽  
Recurrent Gastric Cancer ◽  
Positron Emission ◽  
Unresectable Gastric Cancer

Abstract Background The prognosis of recurrent and unresectable gastric cancer remains poor despite the development of multidisciplinary treatments. Ramucirumab (RAM) has been proven effective against unresectable or recurrent gastric cancer. However, its administration is often discontinued because of adverse events, including hypertension and proteinuria. We report a patient with recurrent gastric cancer involving the paraaortic lymph node (PALN), who achieved long-term survival after repeated RAM administration following long-term drug holidays due to proteinuria. Case presentation A 79-year-old woman was diagnosed with advanced gastric cancer (cT4aN2) with PALN metastasis. Seven courses of S-1 plus cisplatin (SP) achieved downstaging. A distal gastrectomy with D2 lymphadenectomy was performed as a conversion surgery. The pathological diagnosis was ypT3N2M0. The dissected PALN did not contain viable cancer cells. CT and positron emission tomography/CT scans revealed PALN recurrence 1 year after the surgery. S-1 plus oxaliplatin (SOX) therapy was initiated. The recurrent PALN enlarged after seven courses of SOX therapy. Paclitaxel (PTX) plus ramucirumab (RAM) therapy was initiated as second-line chemotherapy. After three courses of PTX plus RAM therapy, a partial response was observed. PTX was discontinued because of a hematological adverse event 3.5 months after PALN recurrence. Disease progression was not observed after six courses of RAM monotherapy. However, RAM caused proteinuria and was withdrawn for 7 weeks. The recurrent PALN was enlarged on CT, and RAM monotherapy was resumed at a reduced dose of 6 mg/kg. The lesion subsequently shrank, but 4 + proteinuria occurred after three courses of RAM monotherapy. Thus, RAM was discontinued. The patient had chemotherapy-free days for 14 months until the PALN was re-enlarged to 13 mm in size. The three administrations of RAM successfully controlled PALN metastasis and proteinuria for 3 years. Conclusion In conclusion, even if RAM withdrawal led to disease progression, re-administration of RAM monotherapy while considering its side effects reduced the tumor size and provided long-term survival benefits.

scholarly journals Long-term survival and prognosis associated with conversion surgery in patients with metastatic gastric cancer

2017 ◽  
Vol 6 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Takahiro Einama ◽  
Hironori Abe ◽  
Shunsuke Shichi ◽  
Hiroki Matsui ◽  
Ryo Kanazawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Metastatic Gastric Cancer ◽  
Conversion Surgery ◽  
Term Survival ◽  
Long Term Survival

Surgical Outcome and Long-Term Survival of Conversion Surgery for Advanced Gastric Cancer

2020 ◽  
Vol 27 (11) ◽  
pp. 4250-4260 ◽  
Author(s):  
Guo-Ming Chen ◽  
Shu-Qiang Yuan ◽  
Run-Cong Nie ◽  
Tian-Qi Luo ◽  
Kai-Ming Jiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Surgical Outcome ◽  
Conversion Surgery ◽  
Term Survival ◽  
Long Term Survival

PS02.142: CONVERSION SURGERY: A FEASIBLE GOAL FOR AFTERWARDS IN CARDIA CANCER TREATMENT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 161-161
Author(s):  
Luca Alberti ◽  
Simone Giacopuzzi ◽  
Carlo Alberto De Pasqual ◽  
Jacopo Weindelmayer ◽  
Roberta La Mendola ◽  
...  
Keyword(s):  
Primary Tumor ◽  
R0 Resection ◽  
Intensive Chemotherapy ◽  
Conversion Surgery ◽  
Cardia Cancer ◽  
Term Survival ◽  
Primary Tumor Site ◽  
Long Term Survival

Abstract Background Conversion surgery is a surgical treatment aiming R0 resection after chemotherapy of tumors that were originally regarded as technically or oncologically unresectable or only marginally resectable. Performing surgery in such patients may result in a long-term survival. The current experience concerns stage IV gastric cancer patients with marginally resectable metastasis, while the evidence concerning cardia tumors are poor. We report a case of primary cardia cancer with potentially unresectable metastasis, successfully treated by a multidisplinary approach including chemotherapy and surgery. Methods We report a case about a 65-year-old man affected by EGJ adenocarcinoma (Siewert II) with multiple hepatic metastases and para-aortic adenopathy (cT3N + M1 according to UICC 7th edition). He received intensive chemotherapy with Taxotere, Cisplatin and 5 FU. After therapy, primary tumor and liver lesions had markedly regressed according to CT, using RECIST guidelines. The endoscopy confirmed the reduction in the cardia lesion with negative biopsies. For that reason, the patient was addressed to follow up. Results After 6 years of follow up, endoscopy indicated a local relapse with a pathological diagnosis of adenocarcinoma. CT scan showed a clinical stage was cT3N + M0. The patient was treated with neoadjuvant concurrent chemoradiotherapy. After treatment the exams showed a partial response. The patient was eligible for conversion surgery and we proceeded to laparotomy total gastrectomy with D2 lymphadenectomy. We performed also exeresis of a liver nodule, which resulted fibrous. The surgical procedure was radical (R0). According to histological examination, the postoperative stage was ypT0N0. Treatment-induced response at the primary tumor site, evaluated according to SPR classification and TRG classification, was SPR 1 and TRG 1. Conclusion Despite limited evidence in literature about conversion surgery in cardia carcinoma, this case shows that intensive chemotherapy allows for conversion of unresectable cardia cancer to resectable cancer, resulting in long-term survival. The following surgical resection provided a R0 resection, leaving no macroscopic residual tumor. This result indicates a potential strategy for patients affected by unresectable cardia cancer. Clearly this strategy requires further analysis to be confirmed. However, based on our case report, the conversion surgery seems safe and feasible, associated with R0 resection. Disclosure All authors have declared no conflicts of interest.

scholarly journals Long-Term Survival of Two Patients with Liver Metastases from Advanced Gastric Cancer Treated with Radiofrequency Ablation and Chemotherapy

2021 ◽  
pp. 67-72
Author(s):  
Sung Jin Oh
Keyword(s):  
Gastric Cancer ◽  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Advanced Gastric Cancer ◽  
Systemic Chemotherapy ◽  
Subtotal Gastrectomy ◽  
Hepatic Metastases ◽  
Term Survival ◽  
Long Term Survival

Liver metastasis from gastric cancer has a very poor prognosis. Herein, we present two cases of liver metastases (synchronous and metachronous) from advanced gastric cancer. In the first case, the patient underwent radical subtotal gastrectomy. Liver metastases occurred 6 months after surgery while the patient was receiving adjuvant chemotherapy, but two hepatic tumors were successfully removed by radiofrequency ablation (RFA). In the second case, liver metastases occurred 15 months after surgery for gastric cancer. The patient also received RFA for one hepatic tumor, and other suspicious metastatic tumors were treated with systemic chemotherapy. Although these case presentations are limited for the efficacy of RFA treatment with systemic chemotherapy for hepatic metastases from gastric cancer, our findings showed long-term survival (overall survival for 108 and 67 months, respectively) of the affected patients, without recurrence. Therefore, we suggest that RFA treatment with systemic chemotherapy could be an effective alternative treatment modality for hepatic metastases from gastric cancer.

Sign in / Sign up

Export Citation Format

Share Document