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Annals of Surgical Oncology

, Volume 22, Issue 11, pp 3618–3624 | Cite as

Prognostic Role of Conversion Surgery for Unresectable Gastric Cancer

  • Minoru Fukuchi
  • Toru Ishiguro
  • Kyoichi Ogata
  • Okihide Suzuki
  • Youichi Kumagai
  • Keiichiro Ishibashi
  • Hideyuki Ishida
  • Hiroyuki Kuwano
  • Erito Mochiki
Gastrointestinal Oncology

Abstract

Background

The prognosis of unresectable gastric cancer is poor. Chemotherapy occasionally converts an initially unresectable gastric cancer to a resectable cancer.

Methods

The responses of noncurative factors to initial chemotherapy and the outcomes of additional (conversion) surgery were retrospectively evaluated in 151 patients with unresectable gastric cancer receiving combination chemotherapy with S-1 plus cisplatin or paclitaxel from February 2003 to December 2013.

Results

Forty (26 %) of 151 patients underwent conversion surgery. After chemotherapy, R0 resection was accomplished in 32 patients (80 %). The 5-year overall survival (OS) rate among the 40 patients who underwent conversion surgery was 43 % (median survival time, 53 months). The 5-year OS rate in the 111 patients treated with chemotherapy alone was 1 % (median survival time, 14 months). Patients who underwent conversion surgery had significantly longer OS times than patients who underwent chemotherapy alone (P < 0.01). The 5-year OS rate among patients who underwent R0 resection was 49 % (median survival time, 62 months). Patients who underwent R0 resection had significantly longer OS times than those who underwent R1 and R2 resection (P = 0.03). Among patients who underwent conversion surgery, multivariate Cox regression analysis showed that one noncurative factor (odds ratio 0.49; 95 % confidence interval 0.28–0.88; P = 0.02) and R0 resection (odds ratio 0.52; 95 % confidence interval 0.28–0.95; P = 0.03) were significant independent predictors for favorable OS.

Conclusions

Patients with unresectable gastric cancer initially exhibiting one noncurative factor may obtain a survival benefit from chemotherapy and subsequent curative surgery.

Keywords

Gastric Cancer Overall Survival Paclitaxel Advanced Gastric Cancer Positive Peritoneal Cytology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Minoru Fukuchi
    • 1
  • Toru Ishiguro
    • 1
  • Kyoichi Ogata
    • 2
  • Okihide Suzuki
    • 1
  • Youichi Kumagai
    • 1
  • Keiichiro Ishibashi
    • 1
  • Hideyuki Ishida
    • 1
  • Hiroyuki Kuwano
    • 2
  • Erito Mochiki
    • 1
  1. 1.Department of Digestive Tract and General Surgery, Saitama Medical CenterSaitama Medical UniversityKawagoeJapan
  2. 2.Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiJapan

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