Efficacy comparison between gastrectomy combined with chemotherapy and chemotherapy alone for treatment of advanced gastric cancer with abdominal para-aortic lymph node metastasis

Objective To investigate the therapeutic effect and prognosis of gastrectomy combined with chemotherapy and chemotherapy alone for treatment of advanced gastric cancer with abdominal para-aortic (the 16th) lymph node metastasis. Methods The clinical data of 236 patients with advanced gastric cancer with abdominal para-aortic (the 16th) lymph node metastasis in Jincheng People's Hospital of Shanxi Province from January 2003 to December 2012 were retrospectively analyzed. According to the treatment method, the patients were divided into chemotherapy alone group (121 cases) and gastrectomy + chemotherapy group (115 cases), and mFOLFOX6 regimen was used for chemotherapy. The efficacy and adverse reactions of the two groups were compared. Results The incidence of upper gastrointestinal adverse events in the gastrectomy+chemotherapy group was higher than that in the chemotherapy alone group [8.7% (10/115) vs. 1.7% (2/121)], and the difference between the two groups was statistically significant (χ 2 = 3.881, P = 0.049). The median overall survival was 14.8 months (10.9-17.8 months) in the chemotherapy alone group and 11.7 months (9.8-15.6 months) in the gastrectomy+chemotherapy group, and there was no significant difference between the two groups (P > 0.05). The 2-year overall survival rate was 32.3% in the chemotherapy alone group and 24.3% in the gastrectomy+chemotherapy group, and there was no significant difference between the two groups (χ 2 = 3.105, P = 0.078). The 2-year progression-free survival rate was 16.5% in the chemotherapy alone group and 20.0% in the gastrectomy+chemotherapy group, and the difference between the two groups was statistically significant (χ 2 = 3.917, P = 0.047). Conclusion Compared with chemotherapy alone, advanced gastric cancer patients with abdominal para-aortic (the 16th) lymph node metastasis could not benefit from gastrectomy combined with chemotherapy. Key words: Stomach neoplasms; Drug therapy, combination; Gastrectomy