CC BY-NC-ND 4.0 · South Asian J Cancer 2018; 07(03): 171-174
DOI: 10.4103/sajc.sajc_2_18
ORIGINAL ARTICLE: Gastro-intestinal & Hepatobiliary Cancer

Metastatic Gastric cancer: Real world scenario from a developing country

Sandip Ganguly
Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
,
Bivas Biswas
Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
,
Joydeep Ghosh
Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
,
Deepak Dabkara
Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
› Author Affiliations
Source of Support: Nill.

Abstract

Aim: Data on epidemiology and outcome in metastatic stomach carcinoma patients from India are scarce. We aimed to evaluate clinical features and treatment outcome in patients treated at our center. Materials and Methods: This is a single institutional review of metastatic gastric carcinoma patients treated between May 2011 and October 2016. Patients who received at least one cycle of chemotherapy were included for modified intent-to-treat survival analysis. Results: A total of 143 patients were diagnosed with metastatic stomach carcinoma with a median age of 56 years (range: 29–86). The most common symptoms were abdominal pain in 112 (78%) patients. The most common site was body in 81 (57%) patients. Common site of metastasis was peritoneum in 86 (60%) and liver in (62%). Seventy-one (50%) patients were eligible for survival analysis. Common chemotherapy regimens were capecitabine-cisplatin in 27 (38%) and EOX in 22 (31%) patients. Survival status could not be assessed in 29 (41%) patients who lost to follow-up. After a median follow-up 9.7 months (range: 0.5–37.7), median progression-free survival (PFS) was 7.9 months (range: 0.5–23.9) and median overall survival (OS) was 12.2 months (range: 0.5–37.7). The Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2 and the presence of linitis plastica showed a trend toward inferior PFS (P = 0.052 and 0.053, respectively) only in univariate analysis. Female sex and ECOG PS ≥2 predicted inferior OS in both univariate and multivariate analysis (P = 0.012, 0.02 and 0.03 and 0.05, respectively). Conclusions: Platinum-based doublet chemotherapy was used in the majority of patients. The overall outcome was comparable to that of the available literature. Female sex and ECOG PS ≥2 predicted the inferior outcome.



Publication History

Article published online:
22 December 2020

© 2018. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Alberts SR, Cervantes A, van de Velde CJ. Gastric cancer: Epidemiology, pathology and treatment. Ann Oncol 2003;14 Suppl 2:ii31-6.
  • 2 Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013.
  • 3 Elimova E, Shiozaki H, Wadhwa R, Sudo K, Chen Q, Estrella SJ, et al. Medical management of gastric cancer:A 2014 update. World J Gastroenterol. 2014;20:13637–47.
  • 4 Kang YK, Kang WK, Shin DB, Chen J, Xiong J, Wang J, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: A randomised phase III noninferiority trial. Ann Oncol 2009;20:666-73.
  • 5 Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36-46.
  • 6 Chen XL, Chen XZ, Yang C, Liao YB, Li H, Wang L, et al. Docetaxel, cisplatin and fluorouracil (DCF) regimen compared with non-taxane-containing palliative chemotherapy for gastric carcinoma: A systematic review and meta-analysis. PLoS One 2013;8:e60320.
  • 7 Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial. Lancet 2010;376:687-97.
  • 8 Tran PN, Sarkissian S, Chao J, Klempner SJ. PD-1 and PD-L1 as emerging therapeutic targets in gastric cancer: Current evidence. Gastrointest Cancer 2017;7:1-1.
  • 9 Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang XS, et al. Global surveillance of cancer survival 1995-2009: Analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 2015;385:977-1010.
  • 10 CTCAE4.0. Available from: https://www.ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm. [Last accessed on 2017 Dec 12].
  • 11 Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-47.
  • 12 StataCorp. Stata Statistical Software: Release 11. College Station, TX: StataCorp LP; 2009.
  • 13 Sharma A, Radhakrishnan V. Gastric cancer in India. Indian J Med Paediatr Oncol 2011;32:12-6.
  • 14 Yang D, Hendifar A, Lenz C, Togawa K, Lenz F, Lurje G, et al. Survival of metastatic gastric cancer: Significance of age, sex and race/ethnicity. J Gastrointest Oncol 2011;2:77-84.
  • 15 Sirohi B, Rastogi S, Dawood S, Talole S, Ramadwar M, Shetty N, et al. Treatment of patients with advanced gastric cancer: Experience from an Indian tertiary cancer center. Med Oncol 2014;31:138.
  • 16 Barad AK, Mandal SK, Harsha HS, Sharma BM, Singh TS. Gastric cancer-a clinicopathological study in a tertiary care centre of North-Eastern India. J Gastrointest Oncol 2014;5:142-7.
  • 17 Riihimäki M, Hemminki A, Sundquist K, Sundquist J, Hemminki K. Metastatic spread in patients with gastric cancer. Oncotarget 2016;7:52307-16.
  • 18 Ahn JB, Ha TK, Kwon SJ. Bone metastasis in gastric cancer patients. J Gastric Cancer 2011;11:38-45.
  • 19 Turkoz FP, Solak M, Kilickap S, Ulas A, Esbah O, Oksuzoglu B, et al. Bone metastasis from gastric cancer: The incidence, clinicopathological features, and influence on survival. J Gastric Cancer 2014;14:164-72.
  • 20 Lee J, Lim T, Uhm JE, Park KW, Park SH, Lee SC, et al. Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma. Ann Oncol 2007;18:886-91.