Clinical Outcome of Palliative Surgery After Translational Therapy for Metastatic Gastric Cancer Versus Maintenance Chemotherapy for Metastatic Gastric Cancer

Inclusion criteria

• Age from 18 to 75 years
• Primary gastric adenocarcinoma (papillary, tubular, mucinous, signet ring cell, or poorly differentiated) confirmed pathologically
• CT/MRI, PET-CT, or laparoscopic exploration should be performed before surgery to confirm the diagnosis of distant metastasis
• Performance status of 0 or 1 on Eastern Cooperative Oncology Group scale (ECOG)
• Estimated survival time was over 3 months
• The major organs are functioning normally and meet the following criteria:

(1) Blood routine examination should meet the requirements (no blood transfusion within 14 days):

• HB≥100g/L，
• WBC≥3×109/L
• ANC≥1.5×109/L，
• PLT≥100×109/L； （2）Biochemical tests must meet the following criteria：

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• BIL <1.5×upper limit of normal (ULN)，
• ALT and AST<2.5ULN，GPT≤1.5×ULN；
• Cr≤1ULN，Ccr >60ml/min
• Fertile women must have taken a pregnancy test (serum) within 7 days prior to enrollment with negative results and be willing to use an appropriate method of contraception during the trial period and 8 weeks after the last trial drug; For men, they should be surgically sterilized or agree to use the appropriate method of contraception during the trial period and 8 weeks after the last administration of the trial drug
• Did not participate in other clinical studies before and during treatment
• Subjects voluntarily joined the study and signed informed consent with good compliance and follow-up

Exclusion criteria

• History of other malignant disease within past five years
• History of immunodeficiency, including HIV positive, or other acquired congenital immunodeficiency disease, or a history of organ transplantation and allogeneic bone marrow transplantation
• Accompanied by serious heart, lung, liver and kidney diseases, neuropsychiatric disorders, jaundice or associated severe infection
• Women during pregnancy or breast-feeding
• Subjects had poorly controlled cardiovascular clinical symptoms or diseases, including but not limited to:

• NYHA class II or more serious heart failure
• unstable angina pectoris
• myocardial infarction within 1 year
• clinically significant ventricular or ventricular arrhythmias that were poorly controlled without or despite clinical intervention