Cancer management and research · 2026
Factors Influencing Survival After Curative Gastrectomy in Oligometastatic Gastric Cancer: A Single-Center Study.
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Yumak Merve, Deniz Abdulkadir, Gursoy Gokturk
Аннотация
BACKGROUND: Gastric cancer remains a major global health burden. Oligometastatic gastric cancer (OMGC) represents an intermediate disease state with limited metastatic spread and potential eligibility for multimodal treatment.
OBJECTIVE: To evaluate clinicopathological factors associated with overall survival (OS) and progression-free survival (PFS) in patients undergoing curative-intent surgery for OMGC.
METHODS: This retrospective study included 38 patients with de novo OMGC who underwent curative-intent gastrectomy between 2011 and 2023. Oligometastatic disease was defined according to OMEC/Bertinoro 2024 criteria: solitary liver metastasis (Group A), para-aortic lymph node metastasis (Group B), or limited peritoneal dissemination (Group C, PCI ≤6). Survival was analyzed using Kaplan-Meier and Cox regression.
RESULTS: Median follow-up was 28 months; 32 patients (84.2%) died. Median OS was 18.0 months. Female sex and age ≥65 years were associated with longer OS (p=0.003 and p=0.001). Adjuvant chemotherapy (HR=0.24; p<0.001) and adjuvant chemoradiotherapy (p=0.039) improved OS. R0 resection rates varied: liver 85.7%, para-aortic 62.5%, peritoneal 12.5%. Five-year OS was 41% for liver metastases vs 0% for peritoneal disease. Harvest of ≥30 lymph nodes was independently associated with improved OS (HR=0.45; p=0.028).
CONCLUSION: Survival in OMGC is strongly influenced by metastatic pattern, adequacy of lymphadenectomy, and adjuvant therapy. Liver metastases have the most favorable prognosis; peritoneal involvement requires highly selective criteria for surgery.
OBJECTIVE: To evaluate clinicopathological factors associated with overall survival (OS) and progression-free survival (PFS) in patients undergoing curative-intent surgery for OMGC.
METHODS: This retrospective study included 38 patients with de novo OMGC who underwent curative-intent gastrectomy between 2011 and 2023. Oligometastatic disease was defined according to OMEC/Bertinoro 2024 criteria: solitary liver metastasis (Group A), para-aortic lymph node metastasis (Group B), or limited peritoneal dissemination (Group C, PCI ≤6). Survival was analyzed using Kaplan-Meier and Cox regression.
RESULTS: Median follow-up was 28 months; 32 patients (84.2%) died. Median OS was 18.0 months. Female sex and age ≥65 years were associated with longer OS (p=0.003 and p=0.001). Adjuvant chemotherapy (HR=0.24; p<0.001) and adjuvant chemoradiotherapy (p=0.039) improved OS. R0 resection rates varied: liver 85.7%, para-aortic 62.5%, peritoneal 12.5%. Five-year OS was 41% for liver metastases vs 0% for peritoneal disease. Harvest of ≥30 lymph nodes was independently associated with improved OS (HR=0.45; p=0.028).
CONCLUSION: Survival in OMGC is strongly influenced by metastatic pattern, adequacy of lymphadenectomy, and adjuvant therapy. Liver metastases have the most favorable prognosis; peritoneal involvement requires highly selective criteria for surgery.