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Background <p>Prognostic factors for conversion surgery in patients with metastatic gastric cancer remain unclear. This study aimed to identify the prognostic factors associated with conversion surgery, and evaluate the safety and survival outcomes of conversion surgery using data from Japanese patients enrolled in the CONVO-GC-1 study.</p> Methods <p>Clinical background, chemotherapy before and after surgery, surgical outcomes, postoperative complications, and survival were analyzed. Prognostic factors were assessed using univariate and multivariate regression analyses.</p> Results <p>A total of 773 Japanese patients were included. Categories 1, 2, 3, and 4 included 345, 156, 225, and 47 patients, respectively. R0 resection was achieved in 571 (73.9%) patients. Incidence rate of Clavien–Dindo grade ≥ III complications was 12.0%. Surgery-related mortality rate was 0.1%. Median overall survival (OS) among patients with R0 resection was 47.8&#xa0;months. The OS of patients with R0 resection by category was 47.6, 116.6, 40.1, and 54.4&#xa0;months for categories 1, 2, 3, and 4, respectively. In the multivariate analysis, male sex (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.30–2.22), undifferentiated histological type (HR, 1.35; 95% CI 1.04–1.75), Eastern Cooperative Oncology Group Performance Status ≥ 1 (HR, 1.57; 95% CI 1.18–2.08), ypT4 (HR,1.79; 95% CI 1.38–2.33), ypN + (HR, 1.92; 95% CI 1.42–2.58), and preoperative chemotherapy duration &lt; 6&#xa0;months (HR, 1.43; 95% CI 1.10–1.87) were poor prognostic factors.</p> Conclusion <p>Conversion surgery was safely performed, yielding favorable survival outcomes in patients with R0 resection. Therefore, careful patient selection is warranted, particularly in those with poor prognostic indicators.</p>

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Safety, survival outcomes, and prognostic factors in conversion surgery for advanced gastric cancer: a sub-analysis of Japanese patients in the CONVO-GC-1 study

  • 期刊论文

  • 发表日期：

    2025年11月18日

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  • Itaru Yasufuku,
  • Takahiro Kinoshita,
  • Etsuro Bando,
  • Yukinori Kurokawa,
  • Muneharu Fujisaki,
  • Hitoshi Ojima,
  • Takaaki Arigami,
  • Seito Fujibayashi,
  • Masahiro Watanabe,
  • Kenichiro Furukawa,
  • Nobuhisa Matsuhashi,
  • Masanori Terashima

摘要

Background

Prognostic factors for conversion surgery in patients with metastatic gastric cancer remain unclear. This study aimed to identify the prognostic factors associated with conversion surgery, and evaluate the safety and survival outcomes of conversion surgery using data from Japanese patients enrolled in the CONVO-GC-1 study.

Methods

Clinical background, chemotherapy before and after surgery, surgical outcomes, postoperative complications, and survival were analyzed. Prognostic factors were assessed using univariate and multivariate regression analyses.

Results

A total of 773 Japanese patients were included. Categories 1, 2, 3, and 4 included 345, 156, 225, and 47 patients, respectively. R0 resection was achieved in 571 (73.9%) patients. Incidence rate of Clavien–Dindo grade ≥ III complications was 12.0%. Surgery-related mortality rate was 0.1%. Median overall survival (OS) among patients with R0 resection was 47.8 months. The OS of patients with R0 resection by category was 47.6, 116.6, 40.1, and 54.4 months for categories 1, 2, 3, and 4, respectively. In the multivariate analysis, male sex (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.30–2.22), undifferentiated histological type (HR, 1.35; 95% CI 1.04–1.75), Eastern Cooperative Oncology Group Performance Status ≥ 1 (HR, 1.57; 95% CI 1.18–2.08), ypT4 (HR,1.79; 95% CI 1.38–2.33), ypN + (HR, 1.92; 95% CI 1.42–2.58), and preoperative chemotherapy duration < 6 months (HR, 1.43; 95% CI 1.10–1.87) were poor prognostic factors.

Conclusion

Conversion surgery was safely performed, yielding favorable survival outcomes in patients with R0 resection. Therefore, careful patient selection is warranted, particularly in those with poor prognostic indicators.