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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 55
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
Outcomes of Locoregional Therapy forMetastatic Gastric Cancer;ANational Cancer DatabaseAnalysis
Ravi Shridhar
Jamie Huston, Kenneth L Meredith
Background:
Patients with metastatic gastric cancer have poor survival. The purpose of this study was to compare outcomes of
metastatic gastric cancer patients with or without surgery and radiation therapy (RT).
Methods:
The National Cancer Database (NCDB) was accessed to identify patients with stage IV gastric cancer between 2004 and
2013 and stratified by surgery. Propensity score matching was performed against age, metastatic site, radiation, and signet ring
histology. Overall survival (OS) analysis was determined by Kaplan-Meier and log-rank analysis. Multivariate analysis (MVA) was
analyzed by the Cox proportional hazard ratio model.
Results:
A total of 1808 patients were identified. Surgery was associated with an OS benefit. Median and 5-year OS for surgery and
no surgery was 16 months and 16% and 10 months and 2%, respectively (p < 0.001). Median and 5 year OS for patients treated with
surgery and RT was 22.4 months and 26%. Median and 5 year OS for surgery patients treated with or without preoperative RT was
27.2 months and 28% and 15.2 months and 12%, respectively (p < 0.001). There was no OS benefit with postoperative RT. MVA
for all patients revealed that surgery and tumor location were associated with decreased mortality while peritoneal metastases were
associated with increased mortality. In surgical patients, MVA showed that RT, partial esophagectomy, and tumor location were
associated with decreased mortality, while positive margins, signet ring histology, and peritoneal metastases were associated with
increased mortality. In nonsurgical patients, only carcinomatosis was prognostic on MVA.
Conclusions:
Surgery and radiation are associated with increased survival in a subset of patients with metastatic gastric cancer.
Prospective trials will be needed to address the role and sequence of surgery and radiation in metastatic gastric cancer.
ravi0421@yahoo.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083