title: The effect of the gastrectomy on survival in patients with metastatic gastric cancer: a study of ASMO.
abstract: OBJECTIVE
  To investigate the role of surgical resection of primary tumor on overall survival (OS) in advanced gastric cancer patients at the time of diagnosis.
  
  
  METHODS
  The survival rates of metastatic gastric cancer patients whose gastric primary tumor was resected at time of diagnosis were compared with metastatic gastric cancer patients whose primary tumor was nonresected.
  
  
  RESULTS
  The median progression-free survival and OS in operated and nonoperated group were 10 versus 6, 14 versus 9 months, respectively (p < 0.001). In multivariate analysis, gastric resection of primary tumor, Eastern Cooperative Oncology Group performance status, second-line chemotherapy had a significant effect on OS (hazard ratio [HR]: 0.52 [95% CI: 0.38-0.71], HR: 0.57 [95% CI: 0.42-0.78], HR: 1.48 [1.09-2.01]; p ≤ 0.001, p = 0.001 and p = 0.012, respectively).
  
  
  CONCLUSIONS
  Subpopulations of patients with metastatic gastric cancer might benefit from surgical removal of primary tumor.
authors.affiliation: Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Yazıcı
authors.affiliation: Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Bilkent Avenue 06800, Ankara, Turkey.
authors.forename: Nuriye
authors.initials: N
authors.lastname: Özdemir
authors.affiliation: Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey.
authors.forename: Ayşe Ocak
authors.initials: AO
authors.lastname: Duran
authors.affiliation: Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Uncubozköy 45030 Manisa, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Menekşe
authors.affiliation: Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Bilkent Avenue 06800, Ankara, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Şendur
authors.affiliation: Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Karaca
authors.affiliation: Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Uncubozköy 45030 Manisa, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Göksel
authors.affiliation: Sakarya University Education & Research Hospital, Department of Medical Oncology, Şirinevler 54100, Sakarya, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Arpacı
authors.affiliation: Trakya University Faculty of Medicine, Department of Medical Oncology, Karaağaç 22050, Edirne, Turkey.
authors.forename: İlhan
authors.initials: İ
authors.lastname: Hacıbekiroğlu
authors.affiliation: Gazi University Faculty of Medicine, Department of Medical Oncology, Emniyet 06560, Ankara, Turkey.
authors.forename: İrem
authors.initials: İ
authors.lastname: Bilgetekin
authors.affiliation: Cumhuriyet University Faculty of Medicine, Department of Medical Oncology, Sivas, Imaret 58140, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Kaçan
authors.affiliation: Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Özkan
authors.affiliation: Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Aksoy
authors.affiliation: İnönü University Faculty of Medicine, Department of Medical Oncology, Malatya, Centre 44000, Turkey.
authors.forename: Asude
authors.initials: A
authors.lastname: Aksoy
authors.affiliation: Izmir Kent Hospital, Department of Medical Oncology, Izmir, Turkey.
authors.forename: Suna
authors.initials: S
authors.lastname: Çokmert
authors.affiliation: Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Mükremin
authors.initials: M
authors.lastname: Uysal
authors.affiliation: İnönü University Faculty of Medicine, Department of Medical Oncology, Malatya, Centre 44000, Turkey.
authors.forename: Emin Tamer
authors.initials: ET
authors.lastname: Elkıran
authors.affiliation: Trakya University Faculty of Medicine, Department of Medical Oncology, Karaağaç 22050, Edirne, Turkey.
authors.forename: İrfan
authors.initials: İ
authors.lastname: Çiçin
authors.affiliation: Gazi University Faculty of Medicine, Department of Medical Oncology, Emniyet 06560, Ankara, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Büyükberber
authors.affiliation: Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: advanced gastric cancer; gastrectomy; resection; survival