https://www.selleckchem.com/btk.html Overall and relapse-free survival rates were significantly better in the ER group than in the non-ER group (p < 0.05 and p < 0.01, respectively). To date, no patients in the ER group experienced disease recurrence. Additional esophagectomy is a safe and effective treatment modality for patients after noncurative ER. Additional esophagectomy is a safe and effective treatment modality for patients after noncurative ER. The authors hypothesized that cytoreductive surgery (CRS, comprising gastrectomy combined with metastasectomy) in addition to systemic chemotherapy (SC) is associated with a better survival than chemotherapy alone for patients with metastatic gastric adenocarcinoma (MGA). Patients with MGA who received SC between 2004 and 2016 were identified using the National Cancer Database (NCDB). Nearest-neighbor 11 propensity score-matching was used to create comparable groups. Overall survival (OS) was compared between subgroups using Kaplan-Meier analyses. Immortal bias analysis was performed among those who survived longer than 90days. The study identified 29,728 chemotherapy-treated patients, who were divided into the following four subgroups no surgery (NS, n=25,690), metastasectomy alone (n=1170), gastrectomy alone (n=2248), and CRS (n=620) with median OS periods of 8.6, 10.9, 14.8, and 16.3 months, respectively (p<0.001). Compared with the patients who underwent NS, the patients who had CRS were younger (58.9±13.4 vs 62.0±13.1years), had a lower proportion of disease involving multiple sites (4.6% vs 19.1%), and were more likely to be clinically occult (cM0 stage 59.2% vs 8.3%) (p<0.001 for all). The medianOS for the propensity-matched patients who underwent CRS (n=615) was longer than for those with NS (16.4 vs 9.3months; p<0.001), including inthose with clinical M1 stage (n=210). In the Cox regression model using the matched data, the hazard ratio for CRS versus NS was 0.56 (95% confidence interval [CI], 0.49-0.63). In