Survival benefits of palliative gastrectomy for gastric cancer patients with liver metastasis: a population-based propensity score-matched cohort analysis

Bingyi Ren; Yichen Yang; Yi Lv; Kang Liu

doi:10.3389/fonc.2023.1309699

Survival benefits of palliative gastrectomy for gastric cancer patients with liver metastasis: a population-based propensity score-matched cohort analysis

Front Oncol. 2023 Dec 1:13:1309699. doi: 10.3389/fonc.2023.1309699. eCollection 2023.

Authors

Bingyi Ren^#^{1

2}, Yichen Yang^#^{1

2}, Yi Lv^{1

2}, Kang Liu^{1

2}

Affiliations

¹ Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
² National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

^# Contributed equally.

Abstract

Background and aims: Palliative primary tumor resection (pPTR) can benefit colorectal cancer patients with liver metastasis. Whether pPTR benefiting gastric cancer (GC) patients with liver metastasis is still controversial.

Methods: Data on patients with metastatic GC diagnosed between 2010 to 2019 was extracted from SEER database. Propensity score analysis with 1:1 matching was performed. The univariable and multivariable Cox proportional hazards regression models were used to explore prognostic factors. Kaplan-Meier method was used to analyze survival outcomes.

Results: Of 5691 GC patients with liver metastasis, 468 were included in the matched cohorts. The results showed that the median survival time was 6 months in the non-surgery groups and 14.5 months in the surgery groups (p < 0.001). Multivariable analysis showed that surgery was a protective prognostic factor for overall survival [hazard ratio (HR) = 0.416] as well as cancer-specific survival (HR = 0.417). Also, pPTR was only recommended for GC patients with isolated liver metastasis. Moreover, pPTR combined with chemotherapy brought the greatest therapeutic effect.

Conclusion: pPTR benefits GC patients with isolated liver metastasis, and GC patients with liver metastasis receiving pPTR combined with chemotherapy had the best survival outcomes than any other therapeutic model.

Keywords: gastric cancer; liver metastasis; palliative gastrectomy; propensity score-matched; survival benefit.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Key R&D Project of Shaanxi Province (No. 2020GXLH-Z-001), the Scientific Development Funding of the First Affiliated Hospital of Xi’an Jiaotong University (No. 2022QN-17) and the Natural Science Basic Research Program of Shaanxi Province (No.2023-JC-QN-0879).