title: [Evaluation of conversion gastrectomy for treatment of Stage IV advanced gastric cancer].
abstract: BACKGROUND
  The standard treatment for Stage IV advanced gastric cancer (AGC) is systemic chemotherapy. Because patients who respond to induction chemotherapy seem to have a good prognosis, we converted the treatment strategy to gastrectomy( termed as conversion gastrectomy) in such patients. In this study, we estimated the outcomes of patients who underwent conversion gastrectomy for Stage IV AGC.
  
  
  METHODS
  We evaluated patients with Stage IV AGC who underwent conversion gastrectomy from October 2008 through September 2012 and retrospectively analyzed their clinicopathological variables and oncologic outcomes.
  
  
  RESULTS
  Twenty patients underwent conversion gastrectomy with an R0 resection rate of 45% (9/20). The median survival time (MST) was 18.0 months overall and did not differ significantly between patients with clinically stable disease( SD) and those with a partial response( PR)( 22.0 months vs 18.0 months, p=0.64). The MST was longer in patients with pathological Grade 1b-3 tumors than in those with Grade 1a tumors (47.8 months vs 16.3 months), and this difference was significant (p=0.04). Patients with R0 resection had a significantly longer MST than those with R1-2 ( 47.8 months vs 14.1 months ).
  
  
  CONCLUSIONS
  The present study provides evidence that patients with Stage IV AGC who undergo conversion gastrectomy with a histopathological response have a good prognosis and that R0 resection predicts longer survival.
authors.affiliation: Dept. of Surgical Oncology, Kanazawa Medical University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funaki
authors.forename: Jun
authors.initials: J
authors.lastname: Fujita
authors.forename: Emi
authors.initials: E
authors.lastname: Morioka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kaida
authors.forename: Toshio
authors.initials: T
authors.lastname: Ohnishi
authors.forename: Yukako
authors.initials: Y
authors.lastname: Ohno
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Tomita
authors.forename: Miki
authors.initials: M
authors.lastname: Noguchi
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakano
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ueda
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome