التفاصيل البيبلوغرافية
| العنوان: |
Surgery for metastases for esophageal-gastric cancer in the real world: Data from the AGAMENON national registry. |
| المؤلفون: |
Carmona-Bayonas, Alberto, Jiménez-Fonseca, Paula, Echavarria, Isabel, Sánchez Cánovas, Manuel, Aguado, Gema, Gallego, Javier, Custodio, Ana, Hernández, Raquel, Viudez, Antonio, Cano, Juana María, Martínez De Castro, Eva, Macías, Ismael, Martín Carnicero, Alfonso, Garrido, Marcelo, Mangas, Monserrat, Álvarez Manceñido, Felipe, Visa, Laura, Azkarate, Aitor, Ramchandani, Avinash, Fernández Montes, Ana |
| المصدر: |
European Journal of Surgical Oncology; Aug2018, Vol. 44 Issue 8, p1191-1198, 8p |
| مصطلحات موضوعية: |
METASTASIS, ESOPHAGEAL cancer patients, CLINICAL trials, ADENOCARCINOMA, MARKOV processes |
| مستخلص: |
Introduction The effect of surgery for metastases in patients with esophagogastric cancer is unknown, given the lack of randomized clinical trials; likewise, the criteria for selecting eligible patients remain to be determined. Methods This registry evaluates the results of patients with advanced adenocarcinoma of the stomach, distal esophagus, or gastro-esophageal junction from 32 centers. To assess selection criteria and prognostic factors, a state arrival extended Markov proportional hazards (PH) model was used. Results 1792 subjects were analyzed, 5% of whom (n = 92) underwent surgery for metastasis. The most common surgeries were peritoneal (29%), hepatic (24%), and distant lymph nodes (11%). Subjects chosen for metastasectomy had higher survival rates, HR 0.34 (95% CI, 0.06–0.80, p = 0.021). Patients who underwent surgery had a mOS since metastasectomy of 16.7 months (95% CI, 12.5–22.4). The 1- and 3-year relapse rates following R0 resection were 58% and 65%, respectively. Median time since R0 metastasectomy until relapse was 8.4 months (95% CI, 7.6–23.7). The 3-year OS after surgery was 30.6% (95% CI, 19.3–40.4). Duration of chemotherapy prior to surgery (months) increased mortality (HR 1.04 [95% CI, 1.01–1.07]), p = 0.009. The only significant interaction involved the use of anti-HER2 therapy. Conclusion The AGAMENON registry suggests that subjects with limited metastatic disease, selected on a clinical basis, can benefit from early surgeries. Prospective trials are needed to confirm these data. [ABSTRACT FROM AUTHOR] |
|
Copyright of European Journal of Surgical Oncology is the property of W B Saunders and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Supplemental Index |
