Abstract

Chemotherapy is generally considered as the main treatment for metastatic gastric adenocarcinoma. The role of gastrectomy for metastatic gastric cancer without obvious symptoms is controversial. The objective of this study is to investigate survival outcomes of treatment modalities using a real-world data setting. A retrospective cohort study was designed using the Taiwan Cancer Registry database. We identified the treatment modalities and used Kaplan–Meier estimates and Cox regressions to compare patient survival outcomes. From 2008 to 2015, 5599 gastric adenocarcinoma patients were diagnosed with metastatic disease (M1). The median overall survival (OS) of patients with surgery plus chemotherapy had the longest survival of 14.2 months. The median OS of the patients who received chemotherapy alone or surgery alone was 7.0 and 3.9, respectively. Age at diagnosis, year of diagnosis, tumor grade, and treatment modalities are prognostic factors for survival. The hazard ratios for patients who received surgery plus chemotherapy, surgery alone, and supportive care were 0.47 (95% CI 0.44–0.51), 1.22 (95% CI 1.1–1.36), and 3.23 (95% CI 3.01–3.46), respectively, by multivariable Cox regression analysis when using chemotherapy alone as a referent. Chemotherapy plus surgery may have a survival benefit for some selected gastric adenocarcinoma patients with metastatic disease.

Details

Title
Survival outcomes of management in metastatic gastric adenocarcinoma patients
Author
Huang-Ming, Hu 1 ; Hui-Jen, Tsai 2 ; Ku Hsiu-Ying 3 ; Su-Shun, Lo 4 ; Yan-Shen, Shan 5 ; Hung-Chi, Chang 6 ; Yee, Chao 7 ; Jen-Shi, Chen 8 ; Shu-Chen, Chen 9 ; Chun-Ju, Chiang 10 ; Li, Anna Fen-Yau 11 ; Wang, Hsiu-Po 12 ; Wang Tsang-En 13 ; Li-Yuan, Bai 14 ; Wu Ming-Shiang 12 ; Li-Tzong, Chen 2 ; Tsang-Wu, Liu 15 ; Yi-Hsin, Yang 16 

 Kaohsiung Medical University Hospital, Kaohsiung Medical University, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.412019.f) (ISNI:0000 0000 9476 5696); Kaohsiung Municipal Ta-Tung Hospital, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.415007.7) (ISNI:0000 0004 0477 6869) 
 Kaohsiung Medical University Hospital, Kaohsiung Medical University, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.412019.f) (ISNI:0000 0000 9476 5696); National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172); National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Department of Oncology, Tainan, Taiwan (GRID:grid.412040.3) (ISNI:0000 0004 0639 0054) 
 National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172); Asia University, Department of Healthcare Administration, Taichung, Taiwan (GRID:grid.252470.6) (ISNI:0000 0000 9263 9645) 
 National Yang Ming Chiao Tung University Hospital, Department of Surgery, Yilan, Taiwan (GRID:grid.252470.6) 
 National Cheng Kung University Hospital, Department of Surgery, Tainan, Taiwan (GRID:grid.412040.3) (ISNI:0000 0004 0639 0054) 
 Chang-Hua Christian Hospital, Changhua, Taiwan (GRID:grid.413814.b) (ISNI:0000 0004 0572 7372) 
 Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Department of Oncology, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314) 
 Linkou Chang Gung Memorial Hospital and Chang Gung University, Department of Hematology-Oncology, Linkou, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922) 
 Chang Gung Memorial Hospital Cancer Center at Linkou, Linkou, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593) 
10  National Taiwan University, and Taiwan Cancer Registry, Institute of Epidemiology and Preventive Medicine, College of Public Health, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241) 
11  National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Taipei Veterans General Hospital, Department of Pathology, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314) 
12  National Taiwan University College of Medicine and Hospital, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241) 
13  Mackay Memorial Hospital, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.413593.9) (ISNI:0000 0004 0573 007X) 
14  China Medical University Hospital, and China Medical University, Division of Hematology and Oncology, Department of Internal Medicine, Taichung, Taiwan (GRID:grid.413593.9) 
15  National Institute of Cancer Research, National Health Research Institutes, Taipei, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172) 
16  National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2604656634
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.