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Multicenter Study
. 2025 Aug:61:102241.
doi: 10.1016/j.suronc.2025.102241. Epub 2025 May 23.

Prognostic impact of conversion surgery in patients with stage IV gastric cancer: A multicenter population-based cohort study

Hirohito Kakinuma  1 , Michitaka Honda  2 , Hidetaka Kawamura  2 , Soshi Hori  2 , Teppei Miyakawa  2 , Satoshi Toshiyama  2 , Yoshinao Takano  3 , Shunji Kinuta  4 , Takahiro Kamiga  5 , Satoru Shiraso  6 , Koji Kono  7
Affiliations
Multicenter Study

Prognostic impact of conversion surgery in patients with stage IV gastric cancer: A multicenter population-based cohort study

Hirohito Kakinuma et al. Surg Oncol. 2025 Aug.

Abstract

Background: The efficacy of conversion surgery (CS) for stage IV advanced gastric cancer (AGC) remains unclear. This study aimed to provide an overview of the clinical practice for Stage IV AGC and to evaluate the effectiveness of CS.

Methods: This is a retrospective cohort study. Consecutive patients diagnosed with stage IV AGC between 2008 and 2015 at designated cancer hospitals in Fukushima Prefecture, Japan, were enrolled in this study. We evaluated the relationship between CS and survival time and calculated the adjusted hazard ratios of CS for overall survival.

Results: A total of 647 patients were enrolled. CS was performed in 57 (8.8 %) patients. The CS group had fewer metastatic lesions (p = 0.01) and fewer liver metastases (p < 0.01) relative to the non-CS group. The adjusted hazard ratios of CS for overall survival were 0.34 (95 % confidence interval: 0.24-0.48, p < 0.01). The median survival time was 28.0 months in the CS group and 8.2 months in the non-CS group.

Conclusion: This study revealed the implementation status of CS for patients with stage IV AGC. CS may improve the patient prognosis.

Keywords: Chemotherapy; Conversion surgery; Gastric cancer.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest in association with the present study.

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