Conversion surgery for gastric cancer patients: A review

Table 1 Patient characteristics and onco-surgical treatments

Reference	Period	Population (conversion surgery)	Median - age	Unresectable criteria						Chemotherapy	Surgery	Lymphadenectomy (D2 or more)	Ro
				P1	H1	Cy1	PAN/N3	T4	Other
Nakajima et al[73], 1997	1989-1995	30 (19)	53	9 (30%)	11 (37%)		23 (77%)	8 (27%)	3 (10%)	FLEP	NS	NS	9 (30%)
Yano et al[74], 2002	May 1994-Dec 1999	34 (14)	54.4 (31-73)	26 (76%)	4 (12%)		10 (3.4%)	12 (35%)	1 (0.3%)	FEMTXP or THP-FLPM	NS	NS	8 (24%)
Satoh et al[75],2012	May 2003-Mar 2008	51 (44)	63 (35-79)	24 (49%)	3 (6%)	12 (23%)	7 (14%)		5 (10%)	S1 + Cisplatin	TG (58%)	82%	26 (51%)
											DG (21.5%)
Kanda et al[76],2012	Apr 2000-Mar 2008	31(28)	65.5 (49-79)	7 (25%)	4 (14.3%)		15 (54%)	9 (32%)		S1 + Cisplatin or Paclitaxel or Irinotecan	TG (42.89%)	96.30%	26 (93%)
											DG (57.1%)
Han et al[77], 2014	Jan 2000-Dec 2009	34 (34)	56 (28-71)	7 (14%)	5 (10%)		15 (29.4%)		7 (14%)	5-FU + Platinum or 5-FU + Platinum + Taxane	NS	NS	26 (76.5%)
Kim et al[78], 2014	Jan 2003-Dec 2012	43 (18)	52.8 (32-72)	43 (100%)						5-FU + Cisplatin or S1 + Cisplatin	TG (72.2%)	100%	10 (55%)
											DG (27.7%)
Fukuchi et al[79], 2015	Feb 2003-Dec 2013	151 (40)	66 (31-79)	11 (28%)	5 (13%)	3 (8%)		6 (15%)	26 (65%)	S1 + Cisplatin or S1 + Paclitaxel	TG (72.5%)	NS	32 (80%)
											DG (27.5%)
Kinoshita et al[80], 2015	Apr 2006-Mar 2012	57 (34)	65 (30-78)	15 (26%)	18 (32%)		23 (40%)		2 (3.5%)	DCS	TG (64.7%)	50%	27 (79%)
											DG (26.5%)
Sato et al[81], 2017	Dec 2002-Apr 2014	100 (33)	63 (26-78)	33 (33%)	29 (29%)		61 (61%)	14 (14%)	11 (11%)	DCS I line, CPT-11 II line	TG (84.8%)	100%	28 (85%)
											DG (12.1%)
Einama et al[82],2017	Jan 2009-Dec 2015	10	70.5 (59-86)	3 (30%)	1 (10%)	1 (10%)	4 (40%)	1 (10%)		S1 + CDDP or DOC	TG (40%)	100%	10 (100%)
											DG (30%)
Mieno et al[83],2017	Oct 2006-Dec 2012	31 (31)	63 (35-78)	25%	16%		58%	26%		DCS + DS (Docetaxel-S1) in responder patients	TG (74.2%)	77%	23 (74%)
											DG (22.6%)
Yamaguchi et al[84], 2017	2001-2013	259 (84)	61.7 (21-78)	35 (41%)			37 (44%)		34 (40%)	DCS or S1 or S1 + Cisplatin or S1 + Taxane	TG (82.1%)	NS	43 (51%)
											DG (17.9%)
Morgagni et al[85], 2018	Apr 2005-Aug 2016	73 (22)	69 (59-74)							Epirubicin + Cisplatinum + 5-FU or Oxaliplatin + 5-FU or Docetaxel + Oxaliplatin + 5-FU or Other	TG (72.7%)	91.90%	22 (100%)
											DG (22.7%)

P1: Peritoneal carcinomatosis; H1: Hepatic metastases; Cy1: Positive cytology; PAN: Para-aortic node metastases; TG: Total gastrectomy; DG: Distal gastrectomy; DCS/DS: Docetaxel-Cisplatin-S1/Docetaxel-Cisplatin; FEMTXP: Fluorouracil, epirubicin, methotrexate, cisplatin; THP-FLPM: Pirarubicin, 5-FU, Leucovorin, Cisplatin, mitomycin C; FLEP: 5-FU + Leucovorin + Etoposide; CDDP: Cisplatin; DOC: Docetaxel; NS: Not specified.

Table 2 Overall survival and median survival time

Reference	Years	OS (rate)			MST (mo)
		CHT	CHT + surgery		CHT	CHT + surgery
			R1/R2	R0		R1/R2	R0
Nakajima et al[73], 1997	2/3-yr				4.7	6.5
	5-yr			55.6
Yano et al[74], 20022	2/3-yr
	5-yr
Satoh et al[75], 2012	2/3-yr		43	751			19.2
	5-yr
Kanda et al[76], 2012	2/3-yr		0	45.9			29
	5-yr			34.4
Han et al[77], 2014	2/3-yr			41.4		7.8	22.9
	5-yr
Kim et al[78], 2014	2/3-yr	0	0	50	8	18	37
	5-yr
Fukuchi et al[79], 2015	2/3-yr				14	30	62
	5-yr	1	15	49
Kinoshita et al[80], 2015	2/3-yr	0	16	63.5	9.6	29.9
	5-yr
Sato et al[81], 2017	2/3-yr	18.7			15.7	21.7	47.9
	5-yr	0	0	48.6
Einama et al[82], 2017	2/3-yr						29
	5-yr
Mieno et al[83], 2017	2/3-yr	56.9		73.1		56.1
	5-yr
Yamaguchi et al[84], 2017	2/3-yr				11.3	21.2	41.3
	5-yr
Morgagni et al[85], 2018	2/3 yr	0		39.4	14		383
	5 yr

¹R0 in only pre-Cy1 patients;

²No data are specified but a P value < 0.0003 is shown between resected and not-resected 5-years OS rate;

³Patients who had cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy had an MST of 50 mo. OS: Overall survival; MST: Median survival time; CHT: Chemotherapy.