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Influence of cancer-directed surgery on the prognosis of liver metastases from gastric cancer

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Abstract

There are controversial about the application of cancer-directed surgery (CDS) in patients with liver metastases from gastric cancer, with improved responses to chemotherapy and targeted treatments, the role of CDS in metastatic gastric cancer to the liver needs to be revisited. This study aimed to evaluate the effect of CDS on patients with liver metastases from gastric cancer. Data for patients with liver metastases from gastric cancer were extracted from the population-based Surveillance, Epidemiology, and End Results (SEER) database. A total of 958 individuals were enrolled, 285 in the CDS group and 673 in the non-cancer guided surgery (Non-CDS) group. Following propensity score matching (PSM) analysis at 1:1 in the two groups,285 were included in the survival analysis for each group. Kaplan–Meier values and Cox proportional risk models were used to estimate the effect of CDS on patients' prognoses. Compared with the Non-CDS group, the CDS group significantly prolonged the median overall survival from 4 months (95% confidence interval [CI] 3–5) to 11 months (95% CI 8–12), p value < 0.001. Overall survival (OS) at 1 year was higher in the CDS group than in the Non-CDS group, at 44% (95 CI 38–50) and 25% (95 CI 20–30), respectively. OS at 3 years was also higher in the CDS group than in the Non-CDS group, at 24% (95 CI 19–29) and 6% (95 CI 3–9), respectively. Multivariate analysis showed that Non-CDS (hazard ratio[HR] = 2.26, 95% CI 1.88–2.72, p value < 0.001) was an adverse independent prognostic factor for patients. This study concludes that CDS prolonged survival in patients with gastric cancer with liver metastases. Due to the lack of information on the quality of life, biomarkers, targeted therapies, and immunotherapy in the SEER database, the observed improved survival rates following CDS of hepatic metastasis from gastric cancer requires prospective studies that take these factors into account to properly address the survival advantages and impact on quality of life of such a method.

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Data availability

The data sets generated during and/or analyzed during the current study are available from SEER.

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Acknowledgements

This work was supported by the Hainan Province's Key Research and Development Project (No. ZDYF2021SHFZ234), the Research Project of Hainan Provincial Health Commission (No. 22A200071), the Hainan Provincial Natural Science Foundation Youth Fund Funding Project (No. 819QN364), and the Funds of Talent Recruitment and Development of The Second Affiliated Hospital of Hainan Medical University.

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Author notes

  1. Nan-Nan Ji and Xiao-Wen Wu have contributed equally to this work and share first authorship.

  2. Yue-Can Zeng and Zhi-Hui Li have contributed equally to this work and share corresponding authorship.

Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Treatment Center, The Second Affiliated Hospital of Hainan Medical University, 368 Yehai Road, Haikou, 570311, China

    Nan-Nan Ji & Yue-Can Zeng

  2. Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, 368 Yehai Road, Haikou, 570311, China

    Xiao-Wen Wu

  3. Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan, China

    Qian Cao & Zhi-Hui Li

  4. Department of Infectious and Tropical Diseases, The Second Affiliated Hospital of Hainan Medical University, 368 Yehai Road, Haikou, 570311, China

    Rui Liu

  5. Department of Gastrointestinal Oncology, The Second Affiliated Hospital of Hainan Medical University, 368 Yehai Road, Haikou, 570311, China

    Wei Tu

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Contributions

All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by NNJ, WT, XWW, and RL. The first draft of the manuscript was written by NNJ. Statistical analysis: QC, ZHL and YCZ, and all authors commented on previous versions of the manuscript and approved the final manuscript.

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Correspondence to Yue-Can Zeng or Zhi-Hui Li.

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The authors declare that there are no conflicts of interest.

Ethical approval and informed consent

This study has been approved by the Ethics Committee of The Second Affiliated Hospital of Hainan Medical University. The access to and use of SEER data did not require informed patient consent.

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Ji, NN., Wu, XW., Cao, Q. et al. Influence of cancer-directed surgery on the prognosis of liver metastases from gastric cancer. Clin Transl Oncol 26, 756–764 (2024). https://doi.org/10.1007/s12094-023-03305-3

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