The surgical and oncological outcomes of conversion surgery for patients with initially unresectable gastric cancer

• Published in: Annals of Cancer Research and Therapy Vol. 26; no. 2; pp. 89 - 94
• Main Authors: Kameyama, Akira, Tauchi, Kastunori, Kishimoto, Hirofumi, Otagiri, Noriaki, Yoshifuku, Seijiro, Kotarou, Sasahara, Ko, Kenju, Nishida, Yasunori, Mishima, Osamu, Misawa, Kenji, Komoto, Tatsuya, Nukui, Asami, Murayama, Daisuke, Sano, Hisao, Nakamura, Masato
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Strategies for Cancer Research and Therapy 21.08.2018; Japan Science and Technology Agency
• Subjects: Chemotherapy; Conversion therapy; Gastric Cancer; Medical prognosis; Surgery; Unresectable gastric cancer
• ISSN: 1344-6835; 1880-5469
• DOI: 10.4993/acrt.26.89

Background: Conversion therapy is a surgical option for unresectable gastric cancer in cases wherein non-curative factors are initially managed by induction chemotherapy. However, the indications for resection remain unclear. Thus, this study aimed to assess the feasibility and efficacy of conversion therapy, based on the data from our facility.Methods: Patients (n=97) with unresectable gastric cancer received chemotherapy in our facility between January 2010 and August 2016. Surgical resection was performed in 16 of them after chemotherapy had rendered the tumor resectable. We retrospectively examined clinicopathological variables and oncologic outcomes in these 16 cases.Results: Of the 16 patients who underwent resection, R0 resection was possible in 15 patients, whereas R1 resection was performed in the remaining 1 patient. Postoperative complications arose in 6 patients (37.5%) but with no mortality. The median overall survival (OS) in the conversion therapy patients (n=16) was 50 months. Among the patients who underwent conversion therapy, univariate analysis showed that the patients with type 4 gastric cancer had a poor prognosis (P=0.0009).Conclusion: The conversion therapy may improve OS in only some of the patients who responded to induction chemotherapy, our results suggest that conversion therapy does not improve the outcomes in patients with type 4 gastric cancer.