Comparing Surgery After Systemic Therapy With Systemic Therapy Alone for Limited Metastatic Gastric Cancer

What this Trial Is About

Researchers are investigating treatment options for metastatic gastric cancer, particularly whether adding surgery to systemic therapy can improve survival. This study focuses on patients with limited metastases inside the abdomen, such as liver or peritoneal spread. Current guidelines favor systemic therapy alone, but recent findings suggest that combining preoperative systemic therapy, surgery, and postoperative therapy may help certain patients live longer, especially those with tumors in specific stomach locations. Participants are randomly assigned to one of two groups one group receives four cycles of systemic therapy followed by cytoreductive gastrectomy surgical removal of part of the stomach if their cancer responds or remains stable, and then continues systemic therapy after surgery. The other group receives systemic therapy alone without surgery. This trial is open-label, meaning both participants and researchers know which treatment is given. During the study, patients will be monitored through imaging and lab tests to assess cancer progression and treatment effects. Researchers will measure median survival time and progression-free survival up to three years after surgery. Secondary outcomes include overall survival, surgical complication rates, cancer response, hospital stay length, and quality of life assessments. The study aims to determine whether surgery combined with systemic therapy improves outcomes compared to systemic therapy alone, with patient safety and treatment feasibility also evaluated.

Cytoreductive Gastrectomy After Systemic Therapy Versus Systemic Therapy Alone For Limited Metastasis Gastric Cancer