Clinical Characteristics Associated with Long-term Survival in Metastatic Gastric Cancer after Systemic Chemotherapy

Background: Systemic chemotherapy for patients with metastatic gastric cancer (MGC) is generallypalliative, although some patients experience long-term survival after treatment. Thus, we identified clinicalcharacteristics that are associated with long-term survival of patients with MGC after palliative chemotherapy.Materials and
Methods: We retrospectively reviewed 514 MGC patients who received systemic chemotherapyat our institution from 2001 to 2008. To identify clinical predictors of survival beyond 2 years, multivariatelogistic regression analyses were performed, and 5-year survival rates were estimated among MGC patientsfollowing chemotherapy.
Results: Among 514 patients, 96 (19%) and 16 (3%) survived beyond 2 and 5 years,respectively, and performance status of 0 or 1 (odds ratio [OR]=3.39; p=0.01), previous gastrectomy (OR=1.86;p=0.01), single metastatic site (OR=1.80; p=0.03), and normal alkaline phosphatase levels (OR=2.81; p<0.01)were identified as independent predictors of long-term survival. Of the 16 5-year survivors, six were alive at theend of the study and showed no evidence of disease despite cessation of chemotherapy.
Conclusions: The presentdata demonstrate distinct clinical characteristics that are associated with long-term survival of MGC patients,and indicated that palliative chemotherapy can be curative in highly selected patients.