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Surgical Outcome and Long-Term Survival of Conversion Surgery for Advanced Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The present study aims to report the surgical outcome and long-term survival of conversion surgery and clarify its role in advanced gastric cancer.

Patients and Methods

A total of 95 primary advanced gastric adenocarcinoma patients who underwent systemic chemotherapy and conversion surgery were reviewed retrospectively. The survival of conversion surgery was analyzed by Cox regression and the Kaplan–Meier method. Surgical outcomes were analyzed according to the Clavien–Dindo classification.

Results

The median survival time (MST) of the 95 patients was 26.8 months, and the postoperative MST was 19.3 months. The MSTs of the patients in categories 1, 2, 3, and 4 were 28.8, 25.5, 43.6, and 11.3 months, respectively. The MSTs of the patients who underwent R0 resection (47 cases) and R1/2 resection (48 cases) were 49.3 months and 21.9 months, respectively. The MST of patients treated with total gastrectomy was shorter (21.9 months) than that of patients who underwent proximal (55.0 months) or distal (46.3 months) gastrectomy. Patients who received more than 6 cycles of induction chemotherapy had a longer MST than patients who received 3–5 cycles or 1–2 cycles (MST: 55.0 months versus 21.1 months versus 21.7 months). The incident postoperative complications and postoperative mortality rates were 10.5% and 1.1%, respectively.

Conclusions

Advanced gastric cancer patients may obtain a survival benefit from conversion surgery, except category 4. Performing a sufficient number of cycles of induction chemotherapy (usually ≥ 6 cycles) is recommended. Surgical oncologists should perform R0 resection and avoid total gastrectomy.

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Funding

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Author notes

  1. Guo-Ming Chen, Shu-Qiang Yuan, Run-Cong Nie, Tian-Qi Luo have contributed equally to this study.

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Department of Gastric Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

    Guo-Ming Chen MD, Shu-Qiang Yuan MD, PhD, Run-Cong Nie MD, PhD, Tian-Qi Luo MD, Kai-Ming Jiang MD, Cheng-Cai Liang MD, PhD, Yuan-Fang Li MD, PhD, De-Yao Zhang MD & Ying-Bo Chen MD

  2. State Key Laboratory of Oncology in South China, Department of Hematological Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

    Yun Wang MD, PhD

  3. State Key Laboratory of Oncology in South China, Department of Gynecology, Sun Yat-sen University Cancer Center, Guangzhou, China

    Jie-Hai Yu MD

  4. Penn Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA

    Fan Hou MA

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  1. Guo-Ming Chen MD
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Correspondence to Yun Wang MD, PhD or Ying-Bo Chen MD.

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Yun Wang, Ying-Bo Chen are co-senior authors.

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Chen, GM., Yuan, SQ., Nie, RC. et al. Surgical Outcome and Long-Term Survival of Conversion Surgery for Advanced Gastric Cancer. Ann Surg Oncol 27, 4250–4260 (2020). https://doi.org/10.1245/s10434-020-08559-7

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