Surgical resection and neoadjuvant therapy in patients with gastric cancer and ovarian metastasis: A real-world study

doi:10.4240/wjgs.v16.i8.2426

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Aug 27, 2024 (publication date) through Mar 5, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Aug 27, 2024; 16(8): 2426-2435
Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2426

Surgical resection and neoadjuvant therapy in patients with gastric cancer and ovarian metastasis: A real-world study

Hui-Ping Yan, Hong-Rui Lu, Yu-Xia Zhang, Liu Yang, Zhe-Ling Chen

Hui-Ping Yan, Zhe-Ling Chen, School of Public Health, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China

Hui-Ping Yan, Hong-Rui Lu, Liu Yang, Zhe-Ling Chen, Cancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou 310000, Zhejiang Province, China

Yu-Xia Zhang, Affiliated Bijie Hospital, Zhejiang Provincial People’s Hospital, Bijie 551700, Guizhou Province, China

Co-first authors: Hui-Ping Yan and Hong-Rui Lu.

Author contributions: Yan HP and Lu HR contributed to the study equally, they are the co-first authors of this article. Yang L and Chen ZL made contribution to conception and design; Yan HP analyzed and interpreted the data; Yan HP, Lu HR, and Zhang YX performed the data collection; Yan HP and Lu HR completed the final version of the article. All authors contributed to this study and agreed to submit the final version.

Institutional review board statement: This study was approved by the ethics committee of our institution (Zhejiang Provincial People’s Hospital Ethics Committee).

Informed consent statement: The informed consent was exempted by the ethics committee.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Corresponding author: Zhe-Ling Chen, MD, Attending Doctor, School of Public Health, Hangzhou Medical College, No. 481 Binwen Road, Hangzhou 310000, Zhejiang Province, China. 383974903@qq.com

Received: March 17, 2024
Revised: June 4, 2024
Accepted: June 26, 2024
Published online: August 27, 2024
Processing time: 152 Days and 11.3 Hours

Abstract

BACKGROUND

Regarding when to treat gastric cancer and ovarian metastasis (GCOM) and whether to have metastatic resection surgery, there is presently debate on a global scale. The purpose of this research is to examine, in real-world patients with GCOM, the survival rates and efficacy of metastatic vs non-metastasized resection.

AIM

To investigate the survival time and efficacy of metastatic surgery and neoadjuvant therapy in patients with GCOM.

METHODS

This study retrospectively analyzed the data of 41 GCOM patients admitted to Zhejiang Provincial People’s Hospital from June 2009 to July 2023. The diagnosis of all patients was confirmed by pathology. The primary study endpoints included overall survival (OS), ovarian survival, OS after surgery (OSAS), disease-free survival (DFS), differences in efficacy.

RESULTS

This study had 41 patients in total. The surgical group (n = 27) exhibited significantly longer median OS (mOS) and median overall months (mOM) compared to the nonoperative group (n = 14) (mOS: 23.0 vs 6.9 months, P = 0.015; mOM: 18.3 vs 3.8 months, P = 0.001). However, there were no significant differences observed in mOS, mOM, median OSAS (mOSAS), and median DFS (mDFS) between patients in the surgical resection plus neoadjuvant therapy group (n = 11) and those who surgical resection without neoadjuvant therapy group (n = 16) (mOS: 26.1 months vs 21.8 months, P = 0.189; mOM: 19.8 vs 15.2 months, P = 0.424; mOSAS: 13.9 vs 8.7 months, P = 0.661, mDFS: 5.1 vs 8.2 months, P = 0.589).

CONCLUSION

Compared to the non-surgical group, the surgical group’s survival duration and efficacy are noticeably longer. The efficacy and survival time of the direct surgery group and the neoadjuvant therapy group did not differ significantly.

Keywords: Gastric cancer; Prognosis; Ovarian metastasis; Neoadjuvant therapy; Surgery

Core Tip: This study found that patients with gastric cancer ovarian metastases (GCOM) who underwent metastatic resection had significantly longer survival and a significantly better prognosis than patients with GCOM who did not undergo surgery. It also found that patients with GCOM who underwent surgery did or did not receive neoadjuvant therapy. There were no statistically significant differences in prognosis or survival time. Finally, a group of patients who would benefit from metastatic resection was screened.