Conversion surgery for stage IV gastric cancer

Abstract

Gastric cancer with distant metastases, such as para-aortic lymph node metastases, hepatic metastases, and peritoneal dissemination, is classified as stage IV. In this situation, cancer cells have formed micrometastases throughout the body; therefore, according to the algorithm of the Japanese guidelines, stage IV cancer is outside the indication for curative resection. Recent advances in some chemical agents have been remarkable, and some patients have survived for long periods even with stage IV gastric cancer. Thus, even in patients with stage IV gastric cancer, there is a possibility that gastrectomy as conversion surgery could play an important role in the treatment strategy. Gastrectomy as conversion therapy can be safely conducted without perioperative mortality and is considered a sufficiently acceptable treatment strategy. However, the significance of conversion surgery for stage IV gastric cancer remains controversial. In this review, we summarize the treatment strategies and outcomes of conversion surgery for stage IV gastric cancer.

Keywords

Gastric cancer / stage IV / gastrectomy / conversion surgery / outcome

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