title: Chemoresponse after non-curative gastrectomy for M1 gastric cancer.
abstract: BACKGROUND
  M1 gastric cancer has a poor oncologic outcome with a median survival of less than 1 year despite aggressive chemotherapy. Recent trials include chemotherapy combined non-curative gastrectomy. This study evaluated the chemoresponse after non-curative gastrectomy in M1 gastric cancer and the survival benefit.
  
  
  METHODS
  Between January 2000 and December 2010, 660 patients received chemotherapy for gastric cancer at the Department of Hemato-Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. Data was collected retrospectively from the medical records. Patients who received preoperative or adjuvant chemotherapy, who underwent other surgeries like gastrojejunal bypass or exploratory laparotomy, who died within 3 months due to seriously advanced gastric cancer, who were lost to follow-up, or whose medical records were unsuitable for data collection were excluded. The remaining 101 patients had received chemotherapy only (CTx group, n = 76) or chemotherapy after non-curative gastrectomy (NCG + CTx group, n = 25). Clinicopathologic characteristics, chemoresponse, and overall survival were compared between the two groups.
  
  
  RESULTS
  There were no significant differences between the two groups in clinicopathologic characteristics including age, sex, body mass index (BMI), comorbidity, histologic differentiation, tumor location, clinical T stage, and initial site of distant metastasis. Chemoresponse was checked on two separate occasions from the initiation of chemotherapy: first chemotherapy regimen and until the third regimen change. The NCG + CTx group showed more favorable chemoresponse than the CTx group in both checks (60% and 72% vs. 18.4% and 23.7%). The NCG + CTx group showed longer overall survival than the CTx group (26 vs. 11 months).
  
  
  CONCLUSIONS
  Non-curative gastrectomy in M1 gastric cancer could improve chemoresponse and extend overall survival.
authors: Department of Surgery, Keimyung University School of Medicine, 194, Dongsan-dong, Choong-gu, Daegu, 700-712, Korea. no1kal@naver.com.
authors: Hyun Beak
authors: HB
authors: Shin
authors: Department of Surgery, Keimyung University School of Medicine, 194, Dongsan-dong, Choong-gu, Daegu, 700-712, Korea. question10@hanmail.net.
authors: Seung Hyoung
authors: SH
authors: Lee
authors: Department of Surgery, Keimyung University School of Medicine, 194, Dongsan-dong, Choong-gu, Daegu, 700-712, Korea. gsgil00@hanmail.net.
authors: Young Gil
authors: YG
authors: Son
authors: Department of Surgery, Keimyung University School of Medicine, 194, Dongsan-dong, Choong-gu, Daegu, 700-712, Korea. gsman@dsmc.or.kr.
authors: Seung Wan
authors: SW
authors: Ryu
authors: Department of Surgery, Keimyung University School of Medicine, 194, Dongsan-dong, Choong-gu, Daegu, 700-712, Korea. sohnss@dsmc.or.kr.
authors: Soo Sang
authors: SS
authors: Sohn
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate
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