title: Role of metastasectomy on overall survival of patients with metastatic gastric cancer.
abstract: OBJECTIVE
  The role of metastasectomy has been debatable and unclear in the treatment for patients with metastatic gastric cancer. Therefore, this study was designed to evaluate the role of metastasectomy on the overall survival of these patients.
  
  
  METHODS
  In 2,406 patients who underwent gastrectomy for gastric cancer between 1998 and 2010, 188 (7.8%) patients had their first surgery for metastatic gastric cancer. To minimize the bias of systemic chemotherapy, 99 patients who received postoperative chemotherapy (fewer than 2 cycles) were excluded. The primary gastrectomy or metastasectomy had not been enforced in the following cases. Patients with far advanced peritoneal dissemination, multiple liver and lung metastasis (more than 2), and a poor general condition (Eastern Cooperative Oncology Group>2) were excluded. Based on the metastasectomy, the patients were classified into two groups, gastrectomy with metastasectomy and gastrectomy only group.
  
  
  RESULTS
  There was no significant difference between both groups in clinicopathological characteristics except for the mean age (P=0.047). The univariate analysis for overall survival show statistical significances in metastasectomy (P=0.026), distal gastrectomy (P=0.047), and combined resection of another organ (P=0.047) group. With a multivariate analysis, metastasectomy was a significant factor in patient survival after surgery (odds ratio 1.679; P=0.034).
  
  
  CONCLUSIONS
  Based on our results, we assume that a detailed strategy for surgery is needed to improve the overall survival of patients with metastatic gastric cancer. Therefore, we suggest that a metastasectomy can help prolong overall survival in some patients with metastatic gastric cancer.
authors: Department of Surgery, Hanyang University Seoul Hospital, Seoul, Korea.
authors: Seung Wook
authors: SW
authors: Yang
authors: Department of Surgery, Hanyang University Seoul Hospital, Seoul, Korea.
authors: Min Gyu
authors: MG
authors: Kim
authors: Department of Surgery, Hanyang University Seoul Hospital, Seoul, Korea.
authors: Ju Hee
authors: JH
authors: Lee
authors: Department of Surgery, Hanyang University Seoul Hospital, Seoul, Korea.
authors: Sung Joon
authors: SJ
authors: Kwon
keywords: Distant metastasis; Gastric cancer; Metastasectomy; Overall survival