Scholarlink

Background <p>Conversion surgery following systemic chemotherapy has emerged as a promising strategy for clinical stage IV gastric cancer. However, the role of postoperative chemotherapy in improving survival outcomes remains unclear. This study aimed to evaluate the impact of postoperative chemotherapy on survival, comparing single-agent and combination regimens.</p> Methods <p>We conducted a single-institution retrospective study of patients who underwent gastrectomy after induction chemotherapy for clinical stage IV gastric cancer between 2007 and 2021. Patients receiving postoperative chemotherapy were categorized into single-agent and combination therapy groups. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier curves and Cox proportional hazard models. Propensity score matching was applied to minimize selection bias.</p> Results <p>Among 128 eligible patients, 45 (35.2%) received single-agent chemotherapy, while 83 (64.8%) received combination therapy. After propensity score matching, 70 patients (35 in each group) were analyzed. The median OS was 29&#xa0;months, and the median PFS was 14&#xa0;months, with no significant differences between single-agent and combination chemotherapy groups (OS: p = 0.841; PFS: p = 0.831). Residual tumor was a strong predictor of poor survival (p = 0.010). Subgroup analysis suggested a potential PFS benefit of combination therapy in ypStage IV patients without residual tumor (p = 0.04).</p> Conclusion <p>Postoperative combination chemotherapy did not significantly improve survival outcomes compared with single-agent regimen in the overall cohort. However, specific subgroups, particularly ypStage IV patients without residual tumor, may benefit from intensified therapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Postoperative chemotherapy after conversion surgery for clinical stage IV gastric cancer: a propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2025年8月27日

查看全文
  • Yasunori Masuike,
  • Takeshi Omori,
  • Kazuyoshi Yamamoto,
  • Yoshitomo Yanagimoto,
  • Yuki Ushimaru,
  • Kei Yamamoto,
  • Takashi Kanemura,
  • Takahito Sugase,
  • Norihiro Matsuura,
  • Ryota Mori,
  • Masatoshi Kitakaze,
  • Masahiko Kubo,
  • Yasunari Fukuda,
  • Hisateru Komatsu,
  • Masaaki Miyo,
  • Toshinori Sueda,
  • Yoshinori Kagawa,
  • Kunihito Goto,
  • Shogo Kobayashi,
  • Masayuki Ohue,
  • Hiroshi Miyata

摘要

Background

Conversion surgery following systemic chemotherapy has emerged as a promising strategy for clinical stage IV gastric cancer. However, the role of postoperative chemotherapy in improving survival outcomes remains unclear. This study aimed to evaluate the impact of postoperative chemotherapy on survival, comparing single-agent and combination regimens.

Methods

We conducted a single-institution retrospective study of patients who underwent gastrectomy after induction chemotherapy for clinical stage IV gastric cancer between 2007 and 2021. Patients receiving postoperative chemotherapy were categorized into single-agent and combination therapy groups. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier curves and Cox proportional hazard models. Propensity score matching was applied to minimize selection bias.

Results

Among 128 eligible patients, 45 (35.2%) received single-agent chemotherapy, while 83 (64.8%) received combination therapy. After propensity score matching, 70 patients (35 in each group) were analyzed. The median OS was 29 months, and the median PFS was 14 months, with no significant differences between single-agent and combination chemotherapy groups (OS: p = 0.841; PFS: p = 0.831). Residual tumor was a strong predictor of poor survival (p = 0.010). Subgroup analysis suggested a potential PFS benefit of combination therapy in ypStage IV patients without residual tumor (p = 0.04).

Conclusion

Postoperative combination chemotherapy did not significantly improve survival outcomes compared with single-agent regimen in the overall cohort. However, specific subgroups, particularly ypStage IV patients without residual tumor, may benefit from intensified therapy.