Zhongyin Yang, Sheng Lu, Min Shi, Hong Yuan, Zhenqiang Wang, Zhentian Ni, Changyu He, Yanan Zheng, Zhenglun Zhu, Wentao Liu, Xuexin Yao, Jun Zhang, Chen Li, Min Yan, Chao Yan, Zhenggang Zhu
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引用次数: 0
Abstract
Background: Data on the long-term oncological outcomes of patients who undergo conversion surgery (CS) in gastric cancer (GC) patients with peritoneal metastasis (PM) are limited.
Methods: GC patients with PM who received intraperitoneal (ip) and systemic chemotherapy between April 2015 and January 2021 were enrolled. Multivariate analysis was performed to identify risk factors associated with survival. Clinicopathological and survival outcomes were compared between those with CS and those without CS (NCS). The paclitaxel (PTX) plus tegafur-gimeracil-oteracil potassium capsules (S-1) (PS) + ip PTX and oxaliplatin plus S-1 (SOX) + ip PTX groups were matched in a 1:1 ratio using propensity score matching. Oncological and survival data were collected and analyzed.
Results: A total of 540 patients who received ip chemotherapy via subcutaneous port and systemic chemotherapy were analyzed and 268 patients were enrolled, including 113 who underwent CS and 155 who did not. Overall survival (OS) were 27.0 months and 11.8 months in the CS and NCS groups (P < 0.0001), respectively. R0 resection was an independent prognostic factor for patients who underwent CS. The OS of patients with or without ovariectomy was 21.3 or 12.0 months (P < 0.0001). No difference of clinicopathological and survival outcomes was found between the PS + ip PTX and SOX + ip PTX groups.
Conclusion: Conversion therapy is safe and adverse events were manageable. CS improves the survival of GC patients with PM after ip and systemic chemotherapy. R0 is an important prognostic factor. Furthermore, outcomes are comparable between the PS + ip PTX and SOX + ip PTX groups.
背景：关于腹膜转移胃癌（GC）患者接受转化手术（CS）的长期肿瘤治疗效果的数据有限：有关腹膜转移（PM）胃癌（GC）患者接受转化手术（CS）的长期肿瘤学结果的数据有限：方法：纳入了2015年4月至2021年1月期间接受腹腔内化疗（ip）和全身化疗的胃癌腹膜转移患者。进行多变量分析以确定与生存相关的风险因素。比较了有CS和无CS（NCS）患者的临床病理和生存结果。紫杉醇（PTX）加替加氟-吉米拉西啶-奥替拉西啶钾胶囊（S-1）（PS）+ ip PTX组和奥沙利铂加S-1（SOX）+ ip PTX组采用倾向评分匹配法按1:1的比例进行匹配。收集并分析了肿瘤学和生存数据：共分析了540名通过皮下端口接受ip化疗和全身化疗的患者，其中268名患者接受了CS治疗，包括113名接受CS治疗的患者和155名未接受CS治疗的患者。CS组和NCS组的总生存期（OS）分别为27.0个月和11.8个月：转换疗法是安全的，不良反应也是可控的。CS可提高ip和全身化疗后患PM的GC患者的生存率。R0是一个重要的预后因素。此外，PS + ip PTX 组和 SOX + ip PTX 组的疗效相当。
期刊介绍：
Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide.
The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics.
Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field.
With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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