This study aims to identify the safety and the survival benefit of the conversion surgery in stage IV or unresectable gastric cancer. The study designed single-arm phase II trial. All the patients would undergo curative-intent radical gastrectomy after palliative chemotherapy if the tumor responded to the chemotherapy. Primary endpoint was three-year overall survival. Secondary endpoints included short-term postoperative outcomes within 30 days, three-year relapse free survival, and success rate of conversion surgery (rate of R0 resection).
The survival rate of patients with stage IV gastric cancer (GC) is very low. Recently, several retrospective studies about conversion surgery have been introduced. The results of the studies showed around 30\~40% of three-year survival rate in conversion surgery group. Eight institutions in Catholic University of Korea analyzed 419 stage IV GC patients, and they had divided into four groups: chemotherapy only, chemotherapy followed by gastrectomy, gastrectomy followed by chemotherapy, and best supportive care group. The group of gastrectomy followed by chemotherapy, which is similar with conversion surgery, showed 40% of three-year survival rate. However, the study included only small number of patients who were in conversion surgery group, and had several biases. Thus, we planned multi-national, multi-center phase II trial for conversion surgery in stage IV or unresectable GC.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Palliative chemotherapy followed by radical gastrectomy
Seoul St. Mary's Hospital
Seoul, South Korea
3-year overall survival
3-year overall survival after conversion surgery
Time frame: 3 years after the surgery
Complication
Short-term complication rate after conversion surgery
Time frame: 30 days after the surgery
3-year disease free survival
3-year disease free survival after conversion surgery
Time frame: 3 years after the surgery
Success rate of conversion surgery
Rate of R0 resection
Time frame: 30 days after the surgery
Response rate of chemotherapy
Response rate of chemotherapy
Time frame: Operation day
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