Significance of volume-reduction surgery for far-advanced gastric cancer during treatment with novel anticancer agents.
BACKGROUND
We retrospectively assessed the survival benefit of novel anticancer agents (NACA) after volume-reduction surgery for far-advanced gastric cancer (FAGC).


METHODS
From 1995 to 2005, 41 patients with FAGC underwent chemotherapy after volume-reduction surgery. Those treated since 2000 who received NACA were referred to as group A, and those treated before 2000, who received anticancer agents other than NACA, were referred to as group B. In addition, 21 patients with unresectable gastric cancer treated since 2000 who received NACA were referred to as group C. We investigated the significance of volume-reduction surgery during treatment with NACA.


RESULTS
The median survival time (MST) was significantly prolonged in group A (626 days) compared to group B (364 days; P = 0.0156). Multivariate analysis showed that having one noncurative factor (NCF), and the use of NACA, were factors that contributed to survival time. Comparison between the subgroup of group A that had one NCF and the subgroup that had two or more NCFs revealed MSTs of 700 days and 180 days, respectively, with a significantly longer MST among the patients with one NCF (P = 0.0021). In addition, no difference from the MST of 333 days in group C was seen among the group A patients with two or more NCFs.


CONCLUSIONS
The postoperative survival time of patients with one NCF was prolonged by the advent of NACA, but no significant prolongation was observed in the patients with two or more NCFs.
Yamamoto
Yuji
Y
Department of Surgery, Kanagawa Prefectural Ashigara-kami Hospital, 866-1 Matsudasouryou, Matsuda-cho, Ashigarakami-gun, Kanagawa, 258-0003, Japan. yu-2@mvc.biglobe.ne.jp
Yoshikawa
Takaki
T
Morinaga
Souichirou
S
Kasahara
Akira
A
Yoneyama
Katsuya
K
Osaragi
Tomohiko
T
Matsuura
Hitoshi
H
Yoshida
Tatsuya
T
Hasegawa
Shinichi
S
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery