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Poster display session

5514 - Prognostic effect of surgery of metastases in patients with advanced gastric cancer: real-world data from the AGAMENON registry


09 Sep 2017


Poster display session


Paula Jiménez-Fonseca


Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369


P. Jiménez-Fonseca1, R. Hernandez2, A. Custodio3, A. Ramchandani Vaswani4, M. Sánchez Cánovas5, R. Sánchez Bayona6, C. López López7, I. Echavarria Diaz-Guardamino8, L. Visa9, E. Buxo Orra10, D. Arias11, A. Viudez12, A. Martin Carnicero13, P. Cerdà14, M. Ferrer15, J.E. Lorenzo Barreto16, M.L. Limón17, I. MACIAS15, P. Felices18

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Central de Asturias, 33011 - Oviedo/ES
  • 2 Medical Oncology, Hospital Universitario de Canarias, Santa Cruz/ES
  • 3 Medical Oncology, Hospital Universitario La Paz, 28046 - Madrid/ES
  • 4 Medical Oncology, Hospital Universitario Insular de Gran Canaria, 35016 - Las Palmas/ES
  • 5 Medical Oncology, Hospital Universitario Morales Meseguer, Murcia/ES
  • 6 Medical Oncology, Clínica Universidad de Navarra, Pamplona/ES
  • 7 Oncology, Hospital Universitario Marqués de Valdecilla, Santander/ES
  • 8 Medical Oncology, Hospital General Universitario Gregorio Marañon, 28007 - Madrid/ES
  • 9 Medical Oncology, University Hospital del Mar, 8003 - Barcelona/ES
  • 10 Medical Oncology, Hospital de Sant Pau, Barcelona/ES
  • 11 Medical Oncology, Hospital de Orense, Orense/ES
  • 12 Medical Oncology, Complejo Hospitalario de Navarra, 31008 - Pamplona/ES
  • 13 Medical Oncology, Hospital San Pedro, 26006 - Logrono/ES
  • 14 Medical Oncology, Tecknon Barcelona, Barcelona/ES
  • 15 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 16 Medical Oncology, Hospital Universitario de Canarias, 38320 - San Cristobal de la Laguna/ES
  • 17 Medical Oncology, Hospital Universitario Virgen del Rocío, Seville/ES
  • 18 Medical Oncology, Hospital Miguel Servet, 50009 - Zaragoza/ES


Abstract 5514


The aim of this analysis was to evaluate the prognostic effect of surgery of metastases in patients from a national registry of advanced gastric cancer.


The effect of surgery of metastases was assessed by multivariable Cox proportional hazards regression adjusted by confounding factors. To avoid immortal time bias in variables that occur after the initial period of observation, surgery of metastases, primary tumor resection, and the assessment of tumor response by RECIST were considered as time-dependent variables. All P values are two-sided. Statistical analyses were performed using RStudio, including the survival package.


The registry contains 1531 evaluable patients. Of these, 5.3% (n = 82) patients underwent surgery for metastases (liver metasectomies were performed in 23 patients, peritoneal surgeries in 39, a pulmonary metastasis excision in 1 patient, and 19 surgeries in other locations). The majority of the cases (53.6%) had a single metastatic location. The median overall survival in non-operated patients was 10.4 months (confidence interval [CI] 95%, 9.9-10.9) versus 19.8 months (CI 95%, 17.4-28.8) in patients with resection of metastases. In the multivariable Cox proportional hazards regression, the resection of metastases was associated with a reduction in mortality with a hazard ratio (HR) of 0.57 (95% CI, 0.43-0.76) (see Table 1). Table 1. Cox proportional hazards regressionTable:


CovariatebHRCI 95%p-value
Surgery of metastases−0.551150.57630.4321- 0.76860.000176
HER2 positive−0.246710.78140.6654- 0.91760.002627
Triplet chemotherapy−0.103370.90180.7966-1.02080.102276
ECOG PS ≥ 20.606461.83391.5660-2.1477


In this registry of patients with advanced gastric tumors, surgery of metastases appears to confer a favorable survival benefit when performed on carefully selected patients.

Clinical trial identification

Legal entity responsible for the study

The investigators




All authors have declared no conflicts of interest.

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