Conversion Surgery for Stage IV Gastric Cancer

Abstract

This study aimed to examine the clinicopathological factors and prognoses of 5 patients with Stage IV gastric cancer(GC) who underwent chemotherapy followed by R0 resection at our institute from 2004 to 2013. Two patients had non-regional lymph node metastases, another 2 patients had peritoneal disseminations, and 1 patient had peritoneal dissemination and non-regional lymph node and left adrenal metastases. All patients underwent R0 resections following 2-6 courses of chemotherapy using multiple anticancer drugs. The disappearance of GC cells in non-regional lymph nodes and peritoneal nodules was confirmed. Clavien-Dindo II or less postoperative complications were found in 3 patients, but no perioperative mortality was observed. The histological response of the primary tumor to preoperative chemotherapy was determined as grade 1b or higher in every case. Although GC recurrence was found in 3 patients, 2 patients are alive without any recurrence. The median survival time of 5 patients was 28(range: 14-61)months. Some patients with Stage IV GC could achieve long-term survival due to chemotherapy followed by R0 resection.