TY - JOUR
T1 - Metastatic gastric cancer (MGC) patients
T2 - Can we improve survival by metastasectomy? A systematic review and meta-analysis
AU - Gadde, Rahul
AU - Tamariz, Leonardo
AU - Hanna, Mena
AU - Avisar, Eli
AU - Livingstone, Alan
AU - Franceschi, Dido
AU - Yakoub, Danny
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Background Prognosis with current management strategies continues to be dismal in metastatic gastric cancer (MGC) patients. We aimed to evaluate the role of metastasectomy in improving survival. Methods A comprehensive search of MEDLINE, EMBASE, SCOPUS, and Cochrane central databases (1965 to present) was performed. All comparative studies measuring survival in MGC patients undergoing metastasectomy versus other therapies were included. Pooled risk ratios with corresponding 95% confidence intervals (CI) were calculated for survival at 1, 3, and 5 years. Results Sixteen studies with 1712 patients (378 patients in metastasectomy, 1334 patients in other therapies) were eligible for the final meta-analysis. Median age was 63 years. For patients undergoing metastasectomy, a significant survival advantage was observed at 1 year (RR 0.52, CI 0.43-0.62), 3 year (RR 0.75 CI 0.67-0.83), and 5 year (RR 0.82, CI 0.74-0.91); mean increased difference in survival conferred by metastasectomy averaged between 9.3 and 15.7 months; P < 0.001 for all results. Age, ECOG status, and STROBE score did not contribute to differences in survival. Conclusion Metastasectomy is associated with increased survival at 1, 3, and 5 years in MGC patients. Large prospective randomized controlled trials are critically needed to evaluate the role of metastasectomy in MGC. J. Surg. Oncol. 2015 111:38-45.
AB - Background Prognosis with current management strategies continues to be dismal in metastatic gastric cancer (MGC) patients. We aimed to evaluate the role of metastasectomy in improving survival. Methods A comprehensive search of MEDLINE, EMBASE, SCOPUS, and Cochrane central databases (1965 to present) was performed. All comparative studies measuring survival in MGC patients undergoing metastasectomy versus other therapies were included. Pooled risk ratios with corresponding 95% confidence intervals (CI) were calculated for survival at 1, 3, and 5 years. Results Sixteen studies with 1712 patients (378 patients in metastasectomy, 1334 patients in other therapies) were eligible for the final meta-analysis. Median age was 63 years. For patients undergoing metastasectomy, a significant survival advantage was observed at 1 year (RR 0.52, CI 0.43-0.62), 3 year (RR 0.75 CI 0.67-0.83), and 5 year (RR 0.82, CI 0.74-0.91); mean increased difference in survival conferred by metastasectomy averaged between 9.3 and 15.7 months; P < 0.001 for all results. Age, ECOG status, and STROBE score did not contribute to differences in survival. Conclusion Metastasectomy is associated with increased survival at 1, 3, and 5 years in MGC patients. Large prospective randomized controlled trials are critically needed to evaluate the role of metastasectomy in MGC. J. Surg. Oncol. 2015 111:38-45.
KW - liver metastasis
KW - metastasectomy
KW - metastatic gastric cancer
KW - neoplasm metastasis
KW - stomach neoplasm
KW - survival rate
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U2 - 10.1002/jso.23945
DO - 10.1002/jso.23945
M3 - Article
C2 - 26074130
AN - SCOPUS:84937509522
SN - 0022-4790
VL - 112
SP - 38
EP - 45
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 1
ER -
