Open AccessCONVERSION SURGERY FOR STAGE IV GASTRIC CANCER. LITERATURE REVIEW AND OWN EXPERIENCE
Author(s) -
V. M. Khomyakov,
Dmitriy Sobolev,
И. В. Колобаев,
A.V. Chayka,
А. Б. Уткина,
A. L. Kornietskaya,
Farkhad Vindiza,
А. B. Ryabov
Publication year - 2020
Publication title -
voprosy onkologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 11
eISSN - 2949-4915
pISSN - 0507-3758
DOI - 10.37469/0507-3758-2020-66-1-50-57
Subject(s) - medicine , cancer , chemotherapy , paraaortic lymph nodes , stage (stratigraphy) , surgery , peritoneal carcinomatosis , randomized controlled trial , metastasis , colorectal cancer , paleontology , biology
Metastatic gastric cancer is associated with poor prognosis despite of advances in chemotherapy and surgery. According to current clinical guidelines surgical treatment for stage IV gastric cancer patients is indicated only for urgent complications. New approach for the management of patients with initially unresectable or metastatic gastric cancer includes primary systemic chemotherapy and following surgical resection if the patients are able to undergo complete resection. This approach is known as conversion surgery. In the review with presentation of own experience the results of conversion surgery for gastric cancer with distant metastases of various localization (liver, paraaortic lymph nodes and peritoneum) were reported. These results allow to define indications for this treatment strategy. 15 conversion surgery cases are presented, 12 of them were combined with HIPEC or PIPAC. Median progression-free survival was 18 months. Conclusion: literature analysis and own experience have shown that conversion surgery after chemotherapy increases the overall survival of patients with oligometastatic gastric cancer who underwent complete resection as compared with palliative chemotherapy. However the clear selection criteria for conversion surgery are needed from randomized controlled trials.