Gastric Cancer With Peritoneal Metastasis—A Comprehensive Review of Current Intraperitoneal Treatment Modalities

Prabhu, Aruna; Mishra, D. C.; Brandl, Andreas; Yonemura, Yutaka

doi:10.3389/fonc.2022.864647

Cited by 25 publications

(16 citation statements)

References 90 publications

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“…In the presence of PC, whenever the patient is deemed resectable and presents a peritoneal cancer index not greater than 6, we advise for standard neoadjuvant chemotherapy, which may be supplemented by 2 concomitant PIPAC to optimize resectability and cure rate. Indeed, PIPAC performed in the context of unresectable GC achieved a pathologic response in more than 60% and allowed conversion to resectability in up to 14% of the patients [ 61 , 63 , 72 , 73 ]. The addition of PIPAC to systemic neoadjuvant chemotherapy further allows for a dynamic laparoscopic response evaluation, including iterative biopsies and tumor regression grading to inform oncologic treatment and resectability of the primary cancer and PC.…”

Section: Resultsmentioning

confidence: 99%

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Adamina

Warlaumont

Berger

et al. 2022

Cancers

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Peritoneal cancer (PC) is a dire finding, yet in selected patients, long-term survival is possible. Complete cytoreductive surgery (CRS) together with combination immunochemotherapy is essential to achieve cure. Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are increasingly added to the multimodal treatment. The Swiss Peritoneal Cancer Group (SPCG) is an interdisciplinary group of expert clinicians. It has developed comprehensive treatment algorithms for patients with PC from pseudomyxoma peritonei, peritoneal mesothelioma, gastric, and colorectal origin. They include multimodal neoadjuvant treatment, surgical resection, and palliative care. The indication for and results of CRS HIPEC and PIPAC are discussed in light of the current literature. Institutional volume and clinical expertise required to achieve best outcomes are underlined, while inclusion of patients considered for CRS HIPEC and PIPAC in a clinical registry is strongly advised. The present recommendations are in line with current international guidelines and provide the first comprehensive treatment proposal for patients with PC including intraperitoneal chemotherapy. The SPCG comprehensive treatment algorithms provide evidence-based guidance for the multimodal care of patients with PC of gastrointestinal origin that were endorsed by all Swiss clinicians routinely involved in the multimodal care of these challenging patients.

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Section: Resultsmentioning

confidence: 99%

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Adamina

Warlaumont

Berger

et al. 2022

Cancers

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“…With the continuous exploration of HIPEC and improvement of its instruments, the application of HIPEC in gastrointestinal tumors has been quite mature ( 23 ). In recent years, a number of studies have suggested that HIPEC does not increase the incidence of postoperative complications ( 24 – 28 ).…”

Section: Discussionmentioning

confidence: 99%

Lobaplatin-based prophylactic hyperthermic intraperitoneal chemotherapy for T4 gastric cancer patients: A retrospective clinical study

Zhong

Kang

et al. 2023

Front. Oncol.

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ObjectiveTo explore the clinical efficacy of lobaplatin-based prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with T4 gastric cancer after surgery and to evaluate its impact on survival.Materials and methodsData on patients with T4 gastric cancer who underwent radical gastric resection between March 2016 and August 2017 were collected from the National Cancer Center and Huangxing Cancer Hospital. Enrolled patients were divided into two groups according to receiving or not receiving HIPEC.ResultsA total of 106 patients were included in this study; among them, 51 patients underwent radical gastric resection plus prophylactic HIPEC, and 55 patients underwent radical gastric resection only. The baseline characteristics were well balanced between the two groups. The postoperative platelet counts in the HIPEC group were significantly lower than those in the non-HIPEC group (P < 0.05); however, we did not observe any occurrences of serious bleeding in the HIPEC group. There were no significant differences in the postoperative complication rates between the two groups (P > 0.05). The postoperative (1 month) CEA, CA19-9, and CA72-4 levels in the HIPEC group were significantly decreased in the HIPEC group (P < 0.05). At a median follow-up of 59.3 months, 3 (5.5%) patients in the HIPEC group experienced peritoneal recurrence, and 10 (18.2%) patients in the non-HIPEC group experienced peritoneal recurrence (P < 0.05). Both groups had comparable 5-year overall survival (OS) rates (41.1% HIPEC group vs. 34.5% non-HIPEC group, P = 0.118). The 5-year disease-free survival was significantly higher in the HIPEC group than in the non-HIPEC group (28.6% versus 39.7%, p = 0.046).ConclusionsLobaplatin-based prophylactic HIPEC is feasible and safe for patients with T4 gastric cancer and does not increase postoperative adverse effects. The use of HIPEC showed a significant decrease in the incidence of local recurrence rates and blood tumor marker levels. The 5-year disease-free survival was significantly higher in the HIPEC group; however, the 5-year OS benefit was not found in T4 stage patients.

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“…Gastric cancer ranks as the third leading cause of cancer-related mortality globally despite being the sixth most prevalent malignancy 1 , 2 . Among the various forms of advanced gastric cancer, peritoneal metastases (PM) represent the most formidable threat to patient survival, with a dismal prognosis 3 – 5 . Even following curative surgery, nearly half of patients with advanced gastric cancer displaying serosal involvement (T4) experience peritoneal recurrences 6 – 8 .…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

Futoh,

Miyato,

Yamaguchi

et al. 2024

Sci Rep

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The vagus nerve is the only pathway for transmitting parasympathetic signals between the brain and thoracoabdominal organs, thereby exhibiting anti-inflammatory functions through the cholinergic anti-inflammatory pathway. Despite often being resected during lymph node dissection in upper gastrointestinal cancer surgery, the impact of vagotomy on postoperative outcomes in gastric cancer patients remains unclear. Sub-diaphragmatic vagotomy was performed on C57BL/6 mice. Three weeks later, syngeneic murine gastric cancer cell line YTN16P was injected into the peritoneal cavity, and the number of peritoneal metastases (PM) on the mesentery and omentum compared with control mice. The phenotypes of immune cells in peritoneal lavage and omental milky spots one day after tumor inoculation were analyzed using flow cytometry and immunohistochemistry. Intraperitoneal transfer of 3 × 105 YTN16P significantly increased the number of metastatic nodules on the mesentery in the vagotomy group compared to the control group. The omental metastasis grade was also significantly higher in the vagotomy group. Phenotypic analysis of immune cells in peritoneal lavage did not reveal significant differences after vagotomy. However, vagotomized mice exhibited a notable increase in milky spot area, with a higher presence of cytokeratin(+) tumor cells, F4/80(+) macrophages, and CD3(+) T cells. Vagus nerve signaling appears to regulate the immune response dynamics within milky spots against disseminated tumor cells and inhibits the development of PM. Preserving the vagus nerve may offer advantages in advanced gastric cancer surgery to reduce peritoneal recurrence.

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Gastric Cancer With Peritoneal Metastasis—A Comprehensive Review of Current Intraperitoneal Treatment Modalities

Cited by 25 publications

References 90 publications

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Lobaplatin-based prophylactic hyperthermic intraperitoneal chemotherapy for T4 gastric cancer patients: A retrospective clinical study

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

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