Abstract 182P
Background
Gastric adenocarcinoma (GA) with peritoneal carcinomatosis is associated with poor prognosis with median overall survival surfacing under the one-year mark. The treatment of gastric cancer remains controversial. Using hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with cytoreductive surgery may help reduce mortality rates. This study attempted to investigate treatment modalities available for metastatic gastric adenocarcinoma.
Methods
We extracted all adult patients with intestinal-type gastric adenocarcinoma with 7th edition AJCC M1 stage (2010-2015) using the Surveillance Epidemiology and End Results (SEER) database. Patients with extra-peritoneal metastasis were excluded. We stratified patients into four different groups: surgery, chemotherapy, surgery and chemotherapy, and no surgery/no chemotherapy. Kaplan-Meier and Cox proportional hazard regression models were utilized to access overall survival (OS) and cancer-specific survival (CSS).
Results
A total of 243 patients were identified. The median (OS) of the entire cohort was 11 months. Patients who received both chemotherapy and surgery, chemotherapy alone, and surgery alone had higher median (OS) compared to no treatment [19, 13, and 6 months, respectively, vs 3 months, p<0.001], as well as a higher (CSS) (p<0.0001). Patients who received no therapy had a statistically significant risk of overall mortality compared to the chemotherapy and surgery group [HR= 9.28 (5.40 -15.94). p<0.001], and compared to other treatment groups (p<0.001). N3B Stage was a significant risk factor for (OS) and (CSS) [HR= 2.69 (1.23 -5.78), p<0.013]. Table: 182P
Median overall survival
| N | Events | Median survival | 95% CI | |
| Overall Survival (OS) | ||||
| No treatment administered | 56 | 54 | 3 | (2- 5) |
| Chemotherapy alone | 91 | 86 | 13 | (11- 17) |
| Surgery alone | 32 | 29 | 6 | (3- 16) |
| Both chemotherapy and surgery | 64 | 55 | 19 | (16- 29) |
| Cancer-Specific Survival (CSS) | ||||
| No treatment administered | 56 | 53 | 3 | (2- 5) |
| Chemotherapy alone | 87 | 75 | 13 | (11-18) |
| Surgery alone | 30 | 21 | 15 | (4-43) |
| Both chemotherapy and surgery | 62 | 49 | 19 | (16-31) |
Conclusions
The combined usage of surgery and chemotherapy significantly improved the median overall and cancer-specific survival for (GA) patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
111P - Comparison of the efficacy and safety of fruquintinib and fruquintinib combined with immune checkpoint inhibitors in the treatment of metastatic microsatellite stable colorectal cancer: A real-world study
Presenter: Zhiqiang Wang
Session: Poster Display
Resources:
Abstract
112P - Optimal classification and treatment strategy based on technical and oncological futures in recurrence of colorectal liver metastases
Presenter: Kosuke Kobayashi
Session: Poster Display
Resources:
Abstract
113P - Phase I/II study of capecitabine(C)/oxaliplatin(O)/irinotecan(I) combined with bevacizumab(B) in the first-line treatment of metastatic colorectal cancer (mCRC)
Presenter: Kai Ou
Session: Poster Display
Resources:
Abstract
114P - The prognostic role of LAG-3 expression in metastatic colorectal cancer
Presenter: Yi-Hsuan Huang
Session: Poster Display
Resources:
Abstract
115P - Sidedness and survival of chemo-refractory metastatic colorectal cancer treated with lonsurf or regorafenib: A nationwide population-based study in Taiwan
Presenter: Meng-Che Hsieh
Session: Poster Display
Resources:
Abstract
116P - Burden and trends of colorectal cancer in high income Asia Pacific countries from 1990-2019 and its projections of deaths to 2040: A comparative analysis
Presenter: Monika Chhayani
Session: Poster Display
Resources:
Abstract
117P - Australasian real-world treatment selection and clinical outcomes for patients with left side (LS), RAS wildtype (RASwt) metastatic colorectal cancer (mCRC)
Presenter: Vanessa Wong
Session: Poster Display
Resources:
Abstract
119P - Neoadjuvant chemoradiotherapy in the mode of hypofractionation in locally advanced rectal cancer: Is it time to change standards of care?
Presenter: Abror Abdujapparov
Session: Poster Display
Resources:
Abstract
120P - Improved clinical outcomes with cetuximab maintenance therapy in left-sided RAS/BRAF wild-type metastatic colorectal cancer: A real-world study of Hunan cancer hospital
Presenter: Xiaolin Yang
Session: Poster Display
Resources:
Abstract
121P - Single-cell sequencing reveals the role of Treg cells with high expression of BIRC3 in regulating the progression of colorectal cancer
Presenter: Yuqiu Xu
Session: Poster Display
Resources:
Abstract