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Conversion Surgery for Stage IV Gastric Cancer
Fei Zhang1, Xuanzhang Huang1, Yongxi Song1
1Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
Conversion surgery, involving radical resection of unresectable stage IV gastric cancer after chemotherapy, shows promise for improved survival. However, optimal strategies for patient selection and treatment timing require further investigation.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Stage IV gastric cancer (GC) typically has a poor prognosis, with palliative chemotherapy as the primary treatment.
- Emerging evidence suggests potential survival benefits for patients with unresectable stage IV GC undergoing radical gastrectomy after chemotherapy response.
Purpose of the Study:
- To review the current status of conversion surgery for unresectable stage IV gastric cancer.
- To highlight the potential of radical resection after chemotherapy in improving survival outcomes.
Main Methods:
- Review of current literature and clinical practices regarding conversion surgery for stage IV GC.
- Analysis of factors influencing outcomes, including chemotherapy regimens, surgical indications, timing, and postoperative management.
Main Results:
- Conversion surgery, defined as radical resection (R0) in initially unresectable stage IV GC after chemotherapy, is associated with significantly improved survival.
- Despite advances, key aspects like chemotherapy selection, surgical indications, optimal timing, and postoperative chemotherapy remain debated.
Conclusions:
- Conversion surgery represents a promising strategy for select patients with unresectable stage IV GC.
- Further research is needed to establish standardized criteria for chemotherapy, surgical indications, timing, and postoperative care to optimize outcomes.
