Comparison of Therapeutic Efficacy between Gastrectomy with Transarterial Chemoembolization Plus Systemic Chemotherapy and Systemic Chemotherapy Alone in Gastric Cancer with Synchronous Liver Metastasis.
- Author:
Sen-Feng LIU
;
Can-Rong LU
;
Hai-Dong CHENG
;
Hong-Qing XI
;
Jian-Xin CUI
;
Ji-Yang LI
;
Wei-Song SHEN
;
Lin CHEN
1
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; administration & dosage; Chemoembolization, Therapeutic; methods; Cohort Studies; Combined Modality Therapy; Deoxycytidine; administration & dosage; analogs & derivatives; Female; Fluorouracil; administration & dosage; analogs & derivatives; Gastrectomy; Humans; Liver Neoplasms; secondary; Male; Middle Aged; Stomach Neoplasms; pathology; therapy
- From: Chinese Medical Journal 2015;128(16):2194-2201
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDSystemic chemotherapy (SC) is the recommended treatment for gastric cancer with liver metastasis. However, the improvement in survival has been disappointing. The aim of this study was to compare the therapeutic efficacy of gastrectomy with transarterial chemoembolization plus SC (GTC) and SC alone for gastric cancer with synchronous liver metastasis.
METHODSFrom January 2008 to December 2013, 107 gastric cancer patients with synchronous liver metastasis attending the four participating centers were enrolled in this multicenter, ambispective, controlled cohort study. Patients who underwent GTC (n = 32) were compared with controls who were received SC alone (n = 75). The primary endpoints of the study were overall survival (OS) and progression-free survival (PFS). The secondary endpoints were response rate to treatment and treatment-related adverse effects.
RESULTSThe median OS was 14.0 months (95% confidence interval [CI ]: 13.1-14.9 months) in the GTC treatment group and 8.0 months (95% CI : 6.6-9.4 months) in SC group, this difference being statistically significant (P < 0.001). The median PFS was significantly longer in the GTC than in the SC group (5 months, 95% CI : 2.2-7.8 months vs. 3 months, 95% CI : 2.3-3.4 months, respectively) (P < 0.001). The rate of response to treatment was significantly better in the GTC than the SC group (59.4% vs. 37.4%, respectively) (P = 0.035). According to multivariate analysis, OS in patients receiving combination treatment was significantly correlated with the size (P = 0.037) and extent of liver metastases (P < 0.001). PFS was also correlated with the extent of liver metastases (P = 0.003).
CONCLUSIONSGTC is more effective than SC alone in patients with gastric cancer with synchronous liver metastasis. GTC therapy prolongs the survival of selected gastric cancer patients with synchronous liver metastasis.
