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Survival Benefits of Palliative Gastrectomy in Stage IV Gastric Cancer: A Propensity Score Matched Analysis

Peng, Wanren, Ma, Tai, Xu, Hui, Wu, Zhijun, Wu, Changhao and Sun, Guoping (2020) Survival Benefits of Palliative Gastrectomy in Stage IV Gastric Cancer: A Propensity Score Matched Analysis Journal of Gastrointenstinal Oncology.

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Background: This study aimed to investigate the effect of palliative gastrectomy on survival in stage IV gastric cancer. Methods: Patients diagnosed with stage IV gastric cancer between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Survival curves were estimated by the Kaplan-Meier method before and after propensity score matching (PSM). Univariate and multivariate Cox analyses were performed to evaluate risk factors for survival in patients who underwent palliative gastrectomy. Results: We examined 6529 patients with stage IV gastric cancer, of which 625 underwent palliative gastrectomy. Using a 1:2 PSM, the 625 patients were matched with 1250 patients from the no gastrectomy group. The overall survival was higher in the gastrectomy group before (hazard ratio [HR] = 0.57, 95% confidence interval [CI]: 0.53–0.62, P < 0.0001) and after PSM (HR = 0.51, 95% CI: 0.46–0.57, P < 0.0001). Multivariate Cox analysis confirmed the survival benefits of palliative gastrectomy and chemotherapy. Older age, over-lapping lesions, non-adenocarcinomas, higher tumor grade, and lung metastasis significantly increased the risk of mortality. In the gastrectomy group, patients aged ≥80 years, diagnosed with grades 3/4 non-adenocarcinomas, or with lung metastasis showed poorer prognosis. However, chemotherapy could improve the survival of these patients. Conclusions: Palliative gastrectomy provides survival benefits to stage IV gastric cancer patients. However, age, tumor grade, tumor histology, and lung metastasis status should be considered while making a decision regarding gastrectomy. Chemotherapy should also be recommended for these patients.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
Peng, Wanren
Ma, Tai
Xu, Hui
Wu, Zhijun
Sun, Guoping
Date : 31 March 2020
Funders : Biotechnology and Biological Sciences Research Council (BBSRC), National Institute of Ageing
DOI : 10.21037/jgo.2020.01.07
Grant Title : Biotechnology and Biological Sciences Research Council (BBSRC) Grant
Uncontrolled Keywords : gastric cancer, palliative gastrectomy, survival analysis
Depositing User : James Marshall
Date Deposited : 30 Mar 2020 11:20
Last Modified : 02 Apr 2020 09:15

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