Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat gastric cancer with ascites and/or peritoneal carcinomatosis: Results from a Chinese center

Yang, Xiaojun; Li, Yan; Yonemura, Yutaka

doi:10.1002/jso.21519

Cited by 87 publications

(45 citation statements)

References 44 publications

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“…Recent studies on GC patients with PM treated with cytoreductive surgery (CRS) and HIPEC reported 1-year OS rates ranging from 35.5 to 50% (Table III) (25)(26)(27)(28)(29)(30)(31)(32). Our results are similar, but considered encouraging, due to the avoidance of surgical trauma.…”

Section: Discussionsupporting

confidence: 79%

A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

Zeng

et al. 2016

Molecular and Clinical Oncology

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Abstract. Peritoneal metastasis (PM) is a poor prognostic factor in patients with gastric cancer. The aim of this study was to evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer with PM by retrospective analysis. A total of 54 gastric cancer patients with positive ascitic fluid cytology were included in this study: 23 patients were treated with systemic chemotherapy combined with HIPEC (HIPEC+ group) and 31 received systemic chemotherapy alone (HIPEC-group). The patients were divided into 4 categories according to the changes of ascites, namely disappear, decrease, stable and increase. The disappear + decrease rate in the HIPEC+ group was 82.60%, which was statistically significantly superior to that of the HIPEC-group (54.80%). The disappear + decrease + stable rate was 95.70% in the HIPEC+ group and 74.20% in the HIPEC-group, but the difference was not statistically significant. In 33 patients with complete survival data, including 12 from the HIPEC+ and 21 from the HIPEC-group, the median progression-free survival was 164 and 129 days, respectively, and the median overall survival (OS) was 494 and 223 days, respectively. In patients with ascites disappear/decrease/stable, the OS appeared to be better compared with that in patients with ascites increase, but the difference was not statistically significant. Further analysis revealed that patients with controlled disease (complete response + partial response + stable disease) may have a better OS compared with patients with progressive disease, with a statistically significant difference. The toxicities were well tolerated in both groups. Therefore, HIPEC was found to improve survival in advanced gastric cancer patients with PM, but the difference was not statistically significant, which may be attributed to the small number of cases. Further studies with larger samples are required to confirm our data.

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Section: Discussionsupporting

confidence: 79%

A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

Zeng

et al. 2016

Molecular and Clinical Oncology

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“…The abstracts of these 145 articles were reviewed carefully and a further 42 articles had full text review. Ultimately, 17 articles were included in this review and summarized in Table 1 [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Of the 17 articles included in the review, 1 was a systematic review, 1 was a randomized controlled trial, 11 were prospective studies (7 case series, 4 case controls and 1 prospective randomized trial) and the remaining 4 were retrospective studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…The completeness of cytoreduction was found to be a prognostic factor in 11 studies [26][27][28][29][30][31][32][33][35][36][37]. Glehen et al showed in 2004 that with a CC score of 0 or 1, the median overall survival improved from 10.3 months to 21.3 months [27].…”

Section: Prognostic Factorsmentioning

confidence: 99%

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Chia

Seshadri

Képénékian³

et al. 2016

Pleura and Peritoneum

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Background: The current treatment of choice for peritoneal carcinomatosis from gastric cancer is systemic chemotherapy. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a new aggressive form of loco-regional treatment that is currently being used in pseudomyxoma peritoneii, peritoneal mesothelioma and peritoneal carcinomatosis from colorectal cancer. It is still under investigation for its use in gastric cancer. Methods: The literature between 1970 and 2016 was surveyed systematically through a review of published studies on the treatment outcomes of CRS and HIPEC for peritoneal carcinomatosis from gastric cancer. Results: Seventeen studies were included in this review. The median survival for all patients ranged from 6.6 to 15.8 months. The 5-years overall survival ranged from 6 to 31%. For patients with complete cytoreduction, the median survival was 11.2 to 43.4 months and the 5-years overall survival was 13 % to 23%. Important prognostic factors were found to be a low peritoneal carcarcinomatosis index (PCI) score and the completeness of cytoreduction.

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“…Even in patients where a CCR-0 cannot be undertaken, a nearly complete resection or CCR-1 can still achieve a longer survival time compared with that of patients with large residual tumor nodules left (10). This implies that a more radical surgery strategy may be taken into consideration.…”

Section: A B C Dmentioning

confidence: 99%

“…The efficacy of IPC in PC of gastric origin has not yet been fully understood, due to the rapid development of the disease and the short patient survival times. However, IPC has been considered as a potential therapy for PC (1,9), with studies demonstrating a median survival time of 6.1-11.5 months after IPC treatment in patients with PC originating from gastric cancer (3,(10)(11)(12). Despite this, the median overall survival (OS) time of patients receiving IPC treatment varies, indicating that there may be confounding factors also affecting survival.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors of intraperitoneal chemotherapy for peritoneal carcinomatosis of gastric cancer: A retrospective study from a single center

et al. 2016

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Abstract. Peritoneal carcinomatosis (PC) of gastric origin is currently recognized as a terminal disease with a poor prognosis. Advancements in novel therapeutic approaches, including intraperitoneal chemotherapy (IPC), have recently been made and it is believed that this may have contributed to the improved survival observed in patients with PC. The present study aimed to investigate overall survival (OS) and the associated prognostic factors in patients with PC of gastric origin who underwent IPC. A total of 57 patients were studied, with a median age of 51 years. The median follow-up time was 12.4 months. PC was diagnosed in all patients with gastric cancer. The median survival time of all patients was 10.1 months, whilst the OS rate at 1, 2 and 3 years was observed to be 46, 19 and 12%, respectively. Symptomatic ascites and a signet ring cell (SRC) histopathological type were demonstrated to signify a poor prognosis. Complete resection of all gross disease (CCR-0) and an increased number of cycles of systemic chemotherapy were independent factors that were observed to correlate with increased OS. The most common morbidities of grade 3/4 adverse effects were bone marrow suppression, nausea or vomiting, and diarrhea. In conclusion, IPC is an important treatment option for patients with PC that has originated from gastric cancer. Symptomatic ascites and SRC adenocarcinoma serve as negative clinicopathological prognostic factors, whilst CCR-0 and increased systemic chemotherapy cycles (≥4 cycles) may prove to be an important therapeutic option for PC patients.

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Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat gastric cancer with ascites and/or peritoneal carcinomatosis: Results from a Chinese center

Abstract: CRS plus HIPEC could offer survival advantage for selected GC patients with PC and/or ascites, with acceptable safety profile.

Cited by 87 publications

References 44 publications

A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

Survival outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from gastric cancer: a systematic review

Prognostic factors of intraperitoneal chemotherapy for peritoneal carcinomatosis of gastric cancer: A retrospective study from a single center

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