Selecting patients for gastrectomy in metastatic esophago-gastric cancer: clinics and pathology are not enough

Lorenzo Fornaro, Valentina Fanotto, Gianna Musettini, Mario Uccello, Lorenza Rimassa, Caterina Vivaldi, Caterina Fontanella, Francesco Leone, Riccardo Giampieri, Gerardo Rosati, Monica Lencioni, Daniele Santini, Samantha Di Donato, Gianluca Tomasello, Oronzo Brunetti, Filippo Pietrantonio, Francesca Bergamo, Mario Scartozzi, Antonio Avallone, Stefania Eufemia LutrinoDavide Melisi, Lorenzo Antonuzzo, Antonio Pellegrino, Lorenzo Gerratana, Stefano Cordio, Enrico Vasile, Giuseppe Aprile

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Abstract

AIM: To evaluate the impact on overall survival (OS) of gastrectomy in asymptomatic metastatic esophago-gastric cancer.PATIENTS & METHODS: Five hundred and thirteen patients were included. The role of surgery and other clinico-pathological factors was evaluated by univariate and Cox regression analyses. OS was the primary end point.RESULTS: Multivariate analysis confirmed that gastrectomy was a predictor of longer OS (p <0.001), as well as preserved performance status and benefit from first-line chemotherapy. None of the investigated clinico-pathological variables identified preferable candidates for surgery (all p > 0.05).CONCLUSION: Palliative gastrectomy might play a role in asymptomatic metastatic esophago-gastric cancer patients with good performance status who received benefit from first-line chemotherapy. Future prospective trials integrating tumor biology among inclusion criteria may help defining the optimal candidates.
Original languageUndefined/Unknown
Pages (from-to)2265-2275
Number of pages11
JournalFuture Oncology
Volume13
Issue number25
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Journal Article

Cite this

Fornaro, L., Fanotto, V., Musettini, G., Uccello, M., Rimassa, L., Vivaldi, C., Fontanella, C., Leone, F., Giampieri, R., Rosati, G., Lencioni, M., Santini, D., Di Donato, S., Tomasello, G., Brunetti, O., Pietrantonio, F., Bergamo, F., Scartozzi, M., Avallone, A., ... Aprile, G. (2017). Selecting patients for gastrectomy in metastatic esophago-gastric cancer: clinics and pathology are not enough. Future Oncology, 13(25), 2265-2275. https://doi.org/10.2217/fon-2017-0246