Table 1.
Unresectable characteristics and conversion surgical treatments.
| Year | References | Unresectable criteria | Chemotherapy | Surgery type | ≥D2 | Conversion surgery (%)* | R0 n (%)** | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| T4 | P1 | H1 | PAN/N3 | Other | |||||||
| 1997 | Nakajima et al. (35) | 8 (27%) | 9 (30%) | 11 (37%) | 23 (77%) | 3 (10%) | FLEP | NS | NS | 19/30 (63.33%) | 9 (47%) |
| 2002 | Yano et al. (36) | 12 (35%) | 26 (76%) | 4 (12%) | 10 (3.4%) | 1 (3.4%) | FEMTXP or THP-FLPM | NS | NS | 14/34 (41.17%) | 8 (57%) |
| 2012 | Satoh et al. (15) | − | 24 (49%) | 3 (6%) | 7 (14%) | 17 (33%) | S1+Cisplatin | TG (58.0%) DG (21.5%) | 82% | 44/51(86.27%) | 26 (59%) |
| 2012 | Kanda et al. (16) | 9 (32%) | 7 (25%) | 4 (14.3%) | 15 (54%) | − | S1 + Cisplatin or Paclitaxel or Irinotecan | TG (42.89%) DG (57.1%) | 96.30% | 28/31 (90.32%) | 26 (93%) |
| 2013 | Han et al. (37) | − | 7 (14%) | 5 (10%) | 15 (29.4%) | 7 (14%) | 5-FU ± Platinum or Taxane ± 5-FU ± Platinum | NS | NS | 34/34 (100%) | 26 (76%) |
| 2014 | Kim et al. (38) | − | 43 (100%) | − | − | − | 5-FU + Cisplatin or S1 + Cisplatin | TG (72.2%) DG (27.7%) | 100% | 18/43 (41.86%) | 10 (55%) |
| 2014 | Saito et al. (39) | 9 (10.22%) | 26 (29.54%) | 7 (7.95%) | 21 (23.86%) | 7 (7.95%) | S-1 + cisplatin | TG (38.4%) DG (61.6%) | 100% | 59/88 (67.04%) | 13 (22%) |
| 2015 | Fukuchi et al. (22) | 6 (15%) | 11 (28%) | 5 (13%) | − | 29 (73%) | S1 + Cisplatin or S1 + Paclitaxel | TG (72.5%) DG (27.5%) | NS | 40/151 (26.49%) | 32 (80%) |
| 2015 | Kinoshita et al. (40) | − | 15 (26%) | 18 (32%) | 23 (40%) | 2 (3.5%) | DCS | TG (64.7%) DG (26.5%) | 50% | 34/57 (59.64%) | 27 (79%) |
| 2017 | Sato et al. (41) | 14 (14%) | 33 (33%) | 29 (29%) | 61 (61%) | 11 (11%) | DCS Iline, CPT-11 II line | TG (84.8%) DG (12.1%) | 100% | 33/100 (33%) | 28 (85%) |
| 2017 | Mieno et al. (42) | 8 (25.8%) | 8 (25.8%) | 5 (16%) | 18 (58%) | − | DCS + DS | TG (74.2%) DG (22.6%) | 77% | 31 | 23 (74%) |
| 2017 | Uemura (43) | 6 (13.9%) | 16 (37.2%) | 14 (32.6%) | 22 (51.2%) | 4 (9.3%) | Modified DCS | NS | 100% | 43/49 (87.75%) | 15 (35%) |
| 2017 | Einama et al. (44) | 1 (10%) | 3 (30%) | 1 (10%) | 4 (40%) | 1 (10%) | S1 + CDDP or DOC | TG (40%) DG (30%) | 100% | 10 | 10 (100%) |
| 2017 | Maeda et al. (45) | − | − | 3 (37.5%) | 8 (100%) | − | Modified DCX | NS | 100% | 3/8 (37.5%) | 3 (100%) |
| 2017 | Yamaguchi et al. (46) | − | 35 (41%) | − | 37 (44%) | 34 (40%) | DCS or S1 or S1 + Cisplatin or S1 + Taxane | TG (82.1%) DG (17.9%) | NS | 84/259 (32.43%) | 43 (51%) |
| 2017 | AIO-FLOT3 (29) | 13 (21.8%) | 4 (6.7%) | 11 (18.3%) | 36 (60.1%) | 2 (3.3%) | FLOT | NS | NS | 36/60 (60%) | 29 (80%) |
| 2018 | Morgagni et al. (47) | 8 (36.36%) | 2 (9.09%) | 2 (9.09%) | 11 (50%) | − | Epirubicin + Cisplatinum + 5-FU or Oxaliplatin + 5-FU or Docetaxel + Oxaliplatin + 5-FU or Other | TG (72.7%) DG (22.7%) | 91.9% | 33/57 (57.89%) | 22 (67%) |
| 2018 | Beom et al. (32) | 2 (2.0%) | 33 (32.7%) | 11 (10.9%) | 35 (34.7%) | 20 (19.8%) | Platinum + 5-FU or Taxane + 5-FU or Platinum + Taxane + 5-FU or Taxane + Platinum or Others | TG (56.4%) DG (43.6%) | 75.2% | 101 | 57 (56%) |
| 2019 | Solaini et al. (48) | − | 38 (84.4%) | 4 (8.8%) | 3 (6.6%) | − | Cisplantin + 5-FU or Epirubicin + Cisplatinum + 5-FU or Docetaxel + Oxaliplatin + 5-FU or Other | TG (73.3%) DG (26.7%) | 91.1% | 45 | 30 (67%) |
| 2019 | Li et al. (49) | − | 8 (9.8%) | 10 (12.2%) | 60 (74.1%) | 3 (3.7%) | Oxaliplatin + 5-FU (Capecitabne or S-1) or Oxaliplatin + 5-FU + Docetaxel/Anthracyclines | NS | NS | 81/414 (19.5%) | 66 (81.4%) |
P1, Peritoneal carcinomatosis; H1, Hepatic metastases; PAN, Para-aortic node metastases; TG, Total gastrectomy; DG, Distal gastrectomy; DCS/DS: Docetaxel-Cisplatin-S1/Docetaxel-Cisplatin; FEMTXP: Fluorouracil, epirubicin, methotrexate, cisplatin; THP-FLPM: Pirarubicin, 5-FU, Leucovorin, Cisplatin, mitomycin C; FLEP: 5-FU + Leucovorin + Etoposide; CDDP: Cisplatin; DOC: Docetaxel; FLOT: fluorouracil, leucovorin, oxaliplatin, and docetaxel;
*
Conversion surgery rate: (conversion surgery number) / population × 100%;
**
R0 resection rate: (R0 resection number) / (conversion surgery number) × 100%; NS: Not specified.