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Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric...

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Autores principales: Minciuna, Corina-Elena, Tudor, Stefan, Micu, Alexandru, Diaconescu, Andrei, Alexandrescu, Sorin Tiberiu, Vasilescu, Catalin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782593/
https://www.ncbi.nlm.nih.gov/pubmed/36557004
http://dx.doi.org/10.3390/medicina58121802
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author Minciuna, Corina-Elena
Tudor, Stefan
Micu, Alexandru
Diaconescu, Andrei
Alexandrescu, Sorin Tiberiu
Vasilescu, Catalin
author_facet Minciuna, Corina-Elena
Tudor, Stefan
Micu, Alexandru
Diaconescu, Andrei
Alexandrescu, Sorin Tiberiu
Vasilescu, Catalin
author_sort Minciuna, Corina-Elena
collection PubMed
description Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection.
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spelling pubmed-97825932022-12-24 Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience Minciuna, Corina-Elena Tudor, Stefan Micu, Alexandru Diaconescu, Andrei Alexandrescu, Sorin Tiberiu Vasilescu, Catalin Medicina (Kaunas) Article Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection. MDPI 2022-12-07 /pmc/articles/PMC9782593/ /pubmed/36557004 http://dx.doi.org/10.3390/medicina58121802 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Minciuna, Corina-Elena
Tudor, Stefan
Micu, Alexandru
Diaconescu, Andrei
Alexandrescu, Sorin Tiberiu
Vasilescu, Catalin
Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title_full Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title_fullStr Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title_full_unstemmed Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title_short Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
title_sort safety and efficacy of simultaneous resection of gastric carcinoma and synchronous liver metastasis—a western center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782593/
https://www.ncbi.nlm.nih.gov/pubmed/36557004
http://dx.doi.org/10.3390/medicina58121802
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