Abstract

Background

In the randomized Asian REGATTA trial, no survival benefit was shown for additional gastrectomy over chemotherapy alone in patients with advanced gastric cancer with a single incurable factor, thereby discouraging surgery for these patients. The purpose of this study was to evaluate treatment strategies for patients with metastatic gastric cancer in daily practice in five European countries, along with relative survival in each country.

Methods

Nationwide population‐based data from Belgium, Denmark, the Netherlands, Norway and Sweden were combined. Patients with primary metastatic gastric cancer diagnosed between 2006 and 2014 were included. The proportion of gastric resections performed and the administration of chemotherapy (irrespective of surgery) within each country were determined. Relative survival according to country was calculated.

Results

Overall, 15 057 patients with gastric cancer were included. The proportion of gastric resections varied from 8·1 per cent in the Netherlands and Denmark to 18·3 per cent in Belgium. Administration of chemotherapy was 39·2 per cent in the Netherlands, compared with 63·2 per cent in Belgium. The 6‐month relative survival rate was between 39·0 (95 per cent c.i. 37·8 to 40·2) per cent in the Netherlands and 54·1 (52·1 to 56·9) per cent in Belgium.

Conclusion

There is variation in the use of gastrectomy and chemotherapy in patients with metastatic gastric cancer, and subsequent differences in survival.

Details

Title
International comparison of treatment strategy and survival in metastatic gastric cancer
Author
Claassen, Y H M 1   VIAFID ORCID Logo  ; Bastiaannet, E 2 ; Hartgrink, H H 1 ; Dikken, J L 1 ; de Steur, W O 1 ; Slingerland, M 3 ; Verhoeven, R H A 4 ; E. van Eycken 5 ; de Schutter, H 5 ; Lindblad, M 6 ; Hedberg, J 7 ; Johnson, E 8 ; Hjortland, G O 9 ; Jensen, L S 10 ; Larsson, H J 11 ; Koessler, T 12 ; Chevallay, M 13 ; Allum, W H 14 ; C. J. H. van de Velde 1 

1  Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands 
2  Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands 
3  Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands 
4  Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands 
5  Belgian Cancer Registry, Brussels, Belgium 
6  Department of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden 
7  Department of Surgical Science, Uppsala University, Uppsala, Sweden 
8  Department of Gastroenterological and Paediatric Surgery, Oslo University Hospital, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway 
9  Institute of Clinical Medicine, University of Oslo, Oslo, Norway 
10  Department of Surgery, Aarhus University Hospital, Aarhus, Denmark 
11  The Danish National Registries, National Quality Improvement Programme (RKKP), Aarhus, Denmark 
12  Department of Medical Oncology, Geneva University Hospital, Geneva, Switzerland 
13  Department of Surgery, Geneva University Hospital, Geneva, Switzerland 
14  Department of Surgery, Royal Marsden NHS Foundation Trust, London, UK 
Pages
56-61
Section
Original articles
Publication year
2019
Publication date
Feb 2019
Publisher
Oxford University Press
e-ISSN
24749842
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/bjs5.103
ProQuest document ID
2287960918
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.