A pragmatic approach improves the clinical management of stage IV gastric cancer: Comparison between the Meta-Gastro results and the GIRCG's retrospective series.

Abstract

INTRODUCTION:

The Italian Research Group for Gastric Cancer developed a prospective database about stage IV gastric cancer, to evaluate how a pragmatic attitude impacts the management of these patients.

MATERIALS AND METHODS:

We prospectively collected data about metastatic gastric cancer patients thanks to cooperation between radiologists, oncologists and surgeons and we analyzed survival and prognostic factors, comparing the results to those obtained in our retrospective study.

RESULTS:

Three-hundred and eighty-three patients were enrolled from 2018 to September 2022. We observed a higher percentage of laparoscopic exploration with peritoneal lavage in the prospective cohort. In the registry only 3.6 % of patients was submitted to surgery without associated chemotherapy, while in the retrospective population 44.3 % of patients were operated on without any chemotherapy. At univariate and multivariate analyses, the different metastatic sites did not show any survival differences among each other (OS 20.0 vs 16.10 vs 16.7 months for lymphnodal, peritoneal and hepatic metastases, respectively), while the number of metastatic sites and the type of treatment showed a statistical significance (OS 16,7 vs 13,0 vs 4,5 months for 1, 2 and 3 different metastatic sites respectively, p < 0.001; 24,2 vs 12,0 vs 2,5 months for surgery with/without chemotherapy, chemotherapy alone and best supportive treatment respectively, p < 0.001).

CONCLUSIONS:

Our data highlight that the different metastatic sites did not show different survivals, but survival is worse in case of multiple localization. In patients where a curative resection can be achieved, acceptable survival rates are possible. A better diagnostic workup and a more accurate staging impact favorably upon survival.

• Authors: Silvia Ministrini, Maria Bencivenga, Federica Filippini, Gianni Mura, Carlo Milandri, Maria Antonietta Mazzei, Giulio Bagnacci, Mattia Berselli, Manlio Monti, Paolo Morgagni, Leonardo Solaini, Daniele Marrelli, Stefania Piccioni, Stefano De Pascale, Luigina Graziosi, Rossella Reddavid, Fausto Rosa, Claudio Belluco, Guido Tiberio, Collaborators
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 50 Issue 1 Pg. 107275 (Jan 2024) ISSN: 1532-2157 [Electronic] England
• PMID: 37995604 (Publication Type: Journal Article)
• Copyright: © 2023 Published by Elsevier Ltd.

Topics

• Humans
• Retrospective Studies
• Stomach Neoplasms (surgery, drug therapy)
• Neoplasm Staging
• Gastrectomy (methods)
• Laparoscopy
• Prognosis
• Survival Rate