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Whether upfront gastrectomy should be used in conjunction with chemotherapy for metastatic gastric cancer is controversial. To resolve the issue, investigators conducted an ambitious phase III, randomized, open-label trial (REGATTA) involving 175 patients in Japan, South Korea, and Singapore with low-volume metastatic gastric cancer with a single noncurable factor, including four or fewer small liver metastases, small-volume peritoneal disease, or low-volume abdominal nodal metastatic disease.
Patients received planned upfront gastrectomy followed by chemotherapy (S-1 and cisplatin) or chemotherapy alone. Most patients had peritoneal metastases (73%–77%), diffuse histology (75%–76%), T3 disease (90%–91%), and N0-1 disease (51%–55%).
The trial…