The Role of Metastasectomy in Patients with Liver-Only Metastases from Gastric Adenocarcinoma.

IF 3.4 2区 医学 Q2 ONCOLOGY
Annals of Surgical Oncology Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI:10.1245/s10434-024-16318-1
Ioannis A Ziogas, Otto N Thielen, Sumaya Abdul Ghaffar, Elliott J Yee, Andrii Khomiak, Jakob A Durden, Sunnie Kim, Richard D Schulick, Ana L Gleisner, Martin D McCarter, Benedetto Mungo
{"title":"The Role of Metastasectomy in Patients with Liver-Only Metastases from Gastric Adenocarcinoma.","authors":"Ioannis A Ziogas, Otto N Thielen, Sumaya Abdul Ghaffar, Elliott J Yee, Andrii Khomiak, Jakob A Durden, Sunnie Kim, Richard D Schulick, Ana L Gleisner, Martin D McCarter, Benedetto Mungo","doi":"10.1245/s10434-024-16318-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The role of metastasectomy in patients with liver-only metastases from gastric adenocarcinoma remains under investigation. Therefore, we performed a national registry analysis comparing surgical treatment options for patients with gastric adenocarcinoma and liver-only metastases.</p><p><strong>Patients and methods: </strong>In this retrospective National Cancer Database (2010-2019) study, adults (≥ 18 years) with gastric adenocarcinoma and liver-only metastases (no brain, bone, or lung metastases) were included. Patients were stratified into four groups: no surgical treatment, primary tumor resection (PTR), liver metastasectomy, and PTR with liver metastasectomy. Survival was evaluated using the Kaplan-Meier method, log-rank test, and Cox regression.</p><p><strong>Results: </strong>Of 10,977 included patients, 93.6% underwent no surgical treatment, 4.6% PTR alone, 0.8% liver metastasectomy alone, and 1.0% both PTR and liver metastasectomy. The median OS after no surgical treatment was 6.5 months, after PTR alone 10.9 months, after liver metastasectomy alone 9.9 months, and after PTR and liver metastasectomy 18.6 months. In multivariable analysis, when adjusting for age, sex, race/ethnicity, insurance status, Charlson-Deyo score, chemotherapy, and radiation, PTR and liver metastasectomy was associated with superior OS compared with no surgical treatment (HR 2.17, 95% CI 1.76-2.69, p < 0.001), PTR alone (HR 1.42, 95% CI 1.12-1.79, p = 0.003), and liver metastasectomy alone (HR 1.96, 95% CI 1.45-2.64, p < 0.001).</p><p><strong>Conclusions: </strong>These data suggest that, in highly selected patients with gastric adenocarcinoma and synchronous liver-only metastases and favorable biology, surgical resection might grant a survival advantage.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"391-398"},"PeriodicalIF":3.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1245/s10434-024-16318-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The role of metastasectomy in patients with liver-only metastases from gastric adenocarcinoma remains under investigation. Therefore, we performed a national registry analysis comparing surgical treatment options for patients with gastric adenocarcinoma and liver-only metastases.

Patients and methods: In this retrospective National Cancer Database (2010-2019) study, adults (≥ 18 years) with gastric adenocarcinoma and liver-only metastases (no brain, bone, or lung metastases) were included. Patients were stratified into four groups: no surgical treatment, primary tumor resection (PTR), liver metastasectomy, and PTR with liver metastasectomy. Survival was evaluated using the Kaplan-Meier method, log-rank test, and Cox regression.

Results: Of 10,977 included patients, 93.6% underwent no surgical treatment, 4.6% PTR alone, 0.8% liver metastasectomy alone, and 1.0% both PTR and liver metastasectomy. The median OS after no surgical treatment was 6.5 months, after PTR alone 10.9 months, after liver metastasectomy alone 9.9 months, and after PTR and liver metastasectomy 18.6 months. In multivariable analysis, when adjusting for age, sex, race/ethnicity, insurance status, Charlson-Deyo score, chemotherapy, and radiation, PTR and liver metastasectomy was associated with superior OS compared with no surgical treatment (HR 2.17, 95% CI 1.76-2.69, p < 0.001), PTR alone (HR 1.42, 95% CI 1.12-1.79, p = 0.003), and liver metastasectomy alone (HR 1.96, 95% CI 1.45-2.64, p < 0.001).

Conclusions: These data suggest that, in highly selected patients with gastric adenocarcinoma and synchronous liver-only metastases and favorable biology, surgical resection might grant a survival advantage.

转移灶切除术在胃腺癌肝转移患者中的作用
背景:转移灶切除术在胃腺癌肝转移患者中的作用仍在研究中。因此,我们进行了一项全国登记分析,比较了胃腺癌肝转移患者的手术治疗方案:在这项全国癌症数据库(2010-2019 年)回顾性研究中,纳入了患有胃腺癌且仅有肝转移(无脑、骨或肺转移)的成年人(≥ 18 岁)。患者被分为四组:无手术治疗组、原发肿瘤切除术(PTR)组、肝转移灶切除术组和PTR加肝转移灶切除术组。采用 Kaplan-Meier 法、对数秩检验和 Cox 回归法评估生存率:结果:在纳入的10977名患者中,93.6%的患者未接受手术治疗,4.6%的患者仅接受了PTR,0.8%的患者仅接受了肝转移切除术,1.0%的患者同时接受了PTR和肝转移切除术。未接受手术治疗的中位生存期为6.5个月,仅接受PTR治疗的中位生存期为10.9个月,仅接受肝转移切除术的中位生存期为9.9个月,同时接受PTR和肝转移切除术的中位生存期为18.6个月。在多变量分析中,当调整年龄、性别、种族/民族、保险状况、Charlson-Deyo评分、化疗和放疗后,PTR和肝转移切除术与不进行手术治疗相比,具有更佳的OS(HR 2.17,95% CI 1.76-2.69,p < 0.001)、单纯 PTR(HR 1.42,95% CI 1.12-1.79,p = 0.003)和单纯肝转移切除术(HR 1.96,95% CI 1.45-2.64,p < 0.001):这些数据表明,对于经过严格筛选的胃腺癌同步肝转移且生物学特性良好的患者,手术切除可能会带来生存优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信