J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 815KB） [Members Only]

J.Jpn. Surg. Soc.. 126(3): 254-260, 2025

Feature topic

CURRENT STATUS OF AND PROSPECTS FOR CONVERSION SURGERY FOR GASTRIC CANCER

1) Department of Clinical Anatomy Development Studies, Gifu University Graduate School of Medicine, Gifu, Japan
2) Department of Gastroenterological and Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
3) Department of Gastroenterological Surgery, Gifu University Hospital, Gifu, Japan

Itaru Yasufuku1), Rintaro Sakamoto2), Ritsuki Takaha2), Seito Fujibayashi2), Wakana Chikaishi2), Masahiro Fukada2), Ryuichi Asai2), Yuta Sato2), Jesse Yu Tajima2), Shigeru Kiyama3), Yoshihiro Tanaka2), Katsutoshi Murase3), Nobuhisa Matsuhashi2)

Conversion surgery is a treatment for patients with metastatic gastric cancer who have shown a remarkable response to chemotherapy, aiming for long-term survival or even cure. The number of clinical reports on conversion surgery is increasing. The CONVO-GC-1 study, a large-scale international retrospective cohort study, included 1,206 stage ⅣB gastric cancer patients and found that the median overall survival of those who underwent R0 resection was 56.6 months. However, conversion surgery has unresolved issues. There is no evidence from randomized controlled trials (RCTs) comparing its efficacy with continuing chemotherapy. Patients who respond well to palliative chemotherapy tend to survive longer, and it is possible that they might survive without surgery. Therefore, the efficacy of conversion surgery should be confirmed through an RCT. The JCOG2301 trial, a phase Ⅲ randomized, controlled trial, is currently underway to investigate the efficacy of conversion surgery in patients with a strong response to palliative chemotherapy, comparing it to continuing chemotherapy. The results of this study are eagerly anticipated to provide more clarity on the role of conversion surgery in these patients.

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