Multimodality Treatment Including Triplet Regimen as First-Line Chemotherapy May Improve Prognosis of Serum AFP-Elevated Gastric Cancer with Liver Metastasis

作者：Wang, Yakun; Shen, Lin; Lu, Ming; Ji, Zhi; Zhang, Xiaotian^*

来源：Gastroenterology Research and Practice, 2017, 2017: 5080361.

DOI：10.1155/2017/5080361

• ALPHA-FETOPROTEIN
• HEPATOID ADENOCARCINOMA
• CLINICOPATHOLOGICAL CHARACTERISTICS
• CARCINOMA
• PATIENT
• CISPLATIN
• FEATURES
• THERAPY
• S-1

Serum alpha-fetoprotein- (AFP-) elevated gastric cancer is a rare tumor that has a poor prognosis due to high incidence of liver metastasis. This study sought to investigate the optimal treatment modality. A total of 319 gastric cancer patients with liver metastasis (GCLM) whose serum AFP levels were tested before treatment were enrolled in this study. They were classified as the serum AFP >= 20 ng/ml group (n = 74) and the AFP < 20 ng/ml group (n = 245). Median OS of the AFP < 20 ng/ml group was significantly longer than that of the AFP >= 20 ng/ml group (15.7 m versus 10.9 m, P = 0 004). ORR of first-line chemotherapy was 43.3% and 56.1% of the two groups, respectively (P = 0 024). Of patients who received doublet regimen, ORR of the AFP = 20 ng/ml group was significantly lower (38.2 versus 56.9%, P = 0 013), while in those received triplet regimens, ORR between two groups was similar (66.7% versus 66.7%, P = 0 676). Moreover, for patients of the AFP = 20 ng/ml group, those who reached PR had a longer survival period (15.4 m versus 9.4 m, P = 0 017), and combined with local treatment for liver metastasis also seemed to improve prognosis (19.2 m versus 8.4 m, P = 0 003). In conclusion, serum AFP-elevated GCLM had a poorer prognosis. Multimodality treatment including aggressive first-line chemotherapy with triplet regimen may be needed when treating them.

• 出版日期2017
• 单位北京大学