Back to Search
Start Over
Palliative Gastrectomy and Survival in Patients With Metastatic Gastric Cancer: A Propensity Score-Matched Analysis of a Large Population-Based Study.
- Source :
-
Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2019 May 22; Vol. 10 (5), pp. 1-8. - Publication Year :
- 2019
-
Abstract
- Objectives: The role of palliative gastrectomy in the management of metastatic gastric cancer remains inadequately clarified.<br />Methods: We analyzed patients with metastatic gastric cancer enrolled in the Surveillance, Epidemiology, and End Results registry from January 2004 to December 2012. Propensity score (PS) analysis with 1:1 matching and the nearest neighbor matching method was performed to ensure well-balanced characteristics of the groups of patients who undergone gastrectomy and those without gastrectomy. Data were analyzed by Kaplan-Meier and Cox proportional hazards regression models to evaluate the overall survival and cancer-specific survival rates with corresponding 95% confidence intervals (CIs).<br />Results: In general, receiving any kind of gastrectomy was associated with an improvement in survival in the multivariate analyses (hazard ratio [HR]os = 0.64, 95% CI = 0.59-0.70, HRcss = 0.63, 95% CI = 0.57-0.68) and PS matching (PSM) analyses (HRos = 0.63, 95% CI = 0.56-0.70, HRcss = 0.62, 95% CI = 0.55-0.70). After PSM, palliative gastrectomy was found to be associated with remarkably improved survival for patients with stage M1 with only 1 metastasis but not associated with survival of patients with stage M1 with extensive metastasis (≥2 metastatic sites).<br />Discussion: The results obtained from the Surveillance, Epidemiology, and End Results database suggest that patients with metastatic gastric cancer might benefit from palliative gastrectomy on the basis of chemotherapy. However, a PSM cohort study of this kind still has a strong selection bias and cannot replace a properly conducted randomized controlled trial.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma secondary
Aged
Aged, 80 and over
Female
Follow-Up Studies
Gastrectomy methods
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Palliative Care methods
Propensity Score
SEER Program statistics & numerical data
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Survival Rate
Time Factors
Treatment Outcome
United States epidemiology
Adenocarcinoma surgery
Gastrectomy statistics & numerical data
Palliative Care statistics & numerical data
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2155-384X
- Volume :
- 10
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical and translational gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 31116140
- Full Text :
- https://doi.org/10.14309/ctg.0000000000000048