Conversion Surgery for Stage 4 GC: Are We Ready?
Speaker
 | Hyung-Ho KIM Professor Department of Surgery Seoul National University, South Korea |
Talk Abstract
Conversion surgery for gastric cancer, particularly in cases of Stage IV with distant metastasis, including peritoneal metastasis, is a topic of growing interest and investigation in the field of oncology. While traditionally considered incurable, recent advancements in surgical techniques, perioperative management, and systemic therapies have led to a reevaluation of the role of surgery in select patients.
Several studies have provided evidence supporting conversion surgery's feasibility and potential benefits in appropriately selected patients. These studies have demonstrated improved survival outcomes and quality of life in patients who undergo successful conversion surgery compared to those treated with systemic therapy alone.
The FREGAT (FRENCH EORTC Gastric Cancer) trial showed that patients with limited peritoneal metastasis who underwent gastrectomy followed by hyperthermic intraperitoneal chemotherapy (HIPEC) had significantly longer overall survival compared to those treated with systemic chemotherapy alone.
Furthermore, several retrospective studies and meta-analyses have reported favorable outcomes in patients undergoing conversion surgery for gastric cancer, particularly in cases where R0 resection (complete removal of visible tumor) can be achieved.
However, it's important to note that patient selection is crucial in determining the appropriateness of conversion surgery. Factors such as tumor biology, extent of metastasis, performance status, and response to preoperative systemic therapy should be carefully considered by a multidisciplinary team when evaluating candidates for surgery.
In conclusion, while conversion surgery for stage IV gastric cancer with distant metastasis, including peritoneal metastasis, remains a complex and evolving area of research, accumulating evidence suggests that it can offer survival benefits and improved quality of life in select patients. Ongoing clinical trials and further research are needed to refine patient selection criteria and optimize treatment strategies in this setting.