Hyperthermo‐chemotherapy combined with cytoreductive surgery for the treatment of gastric cancer with peritoneal dissemination

Yonemura, Yutaka; Fujimura, Takashi; Fushida, Sachio; Takegawa, Shigeru; Kamata, Toru; Katayama, Kanji; Kosaka, Takeo; Yamaguchi, Akio; Miwa, Kouichi; Miyazaki, I

doi:10.1007/bf01675656

Cited by 131 publications

(88 citation statements)

References 12 publications

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“…Yonemura et al introduced a 'peritoneal access device' to achieve optimal peritoneal expansion. According to this technique, larger volumes of perfusion fluid can be added allowing the small bowel to float in the cavity expander [47]. A major advantage of these open techniques is the creation of controlled distribution of heat and the cytotoxic drugs however, disadvantages are also heat loss and possible drug leakage, increasing potential exposure to theatre staff [48].…”

Section: Perfusion Techniquesmentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Valle

Alzahrani

Sugarbaker

et al. 2016

Indian J Surg Oncol

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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) combined have been recognized as standard of care for treatment of a subset of patients with peritoneal carcinomatosis (PC). The aim of CRS is to eliminate all macroscopic disease through a series of visceral resections followed by targeting any residual microscopic disease with intraperitoneal chemotherapy, exposing the peritoneal surfaces to a high concentration of chemotherapy with a lower systemic toxicity. Different regimes of intraperitoneal chemotherapy include HIPEC, early postoperative intraperitoneal chemotherapy (EPIC) and bidirectional chemotherapy. The efficacy and modality of treatment with intraperitoneal chemotherapy is dependent on multiple factors including the chosen cytotoxic agent and its pharmacokinetics and pharmacodynamics. There is no standardized methodology for intraperitoneal chemotherapy administration. This review will discuss the pharmacological principles of the various intraperitoneal chemotherapy techniques.

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Section: Perfusion Techniquesmentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Valle

Alzahrani

Sugarbaker

et al. 2016

Indian J Surg Oncol

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“…The mortality is < 6% and the 1-year survival 75%. Furthermore, ascites was controlled in 11 of 12, nine of 15 and seven of nine patients [18][19][20]. The present is the first prospective trial in patients with malignant ascites associated with peritoneal carcinomatosis in urological cancer.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of disseminated peritoneal metastases from urological cancer: results from a prospective study

Otto

Suhr²,

Krege

et al. 2002

BJU International

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Objective To report a prospective phase II study of patients with disseminated peritoneal carcinomatosis and symptomatic disease, in whom the peritoneal metastases were resected. Patients and methods From 1995From to 1999 (20 men and 12 women, median age 56 years, range 32-75) with peritoneal carcinomatosis were enrolled in the trial. Pain and ascites were determined according to the National Cancer Institute score/criteria, and performance scored according to the World Health Organisation criteria. Results All patients had intraperitoneal disseminated malignancies with clinically evident ascites, and presented with abdominal pain. The median (range) operative duration was 2.9 (1-5.5) h and the hospital stay 25 (10-44) days, with no deaths at 30 days. The ascites was completely cured in 25 of the 32 patients, pain relieved in 28 and the performance score improved in 25. The median survival time was 1 year; the 1-and 2-year survival rates were 45% and 38%, respectively. Patients with residual metastases after incomplete resection had a significantly worse prognosis, but the prognosis was significantly better in those with a low tumour burden. Conclusions Peritoneal carcinomatosis is treatable; radical peritonectomy improves the performance score in selected patients with cancer-related ascites and/or pain, and is now the standard approach in the authors' Cancer Centre.

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“…None of the treatment options including repeated paracentesis, diuretics and systemic chemotherapy result in a permanent resolution of the ascites. Earlier reports of complete disappearance of ascites in patients with PM from gastric cancer who underwent HIPEC suggest its efficacy in this clinical setting [53,55]. Recently, laparoscopic HIPEC has been used to palliate patients with intractable ascites requiring repeated paracenteses [76,77].…”

Section: Hipec For Palliationmentioning

confidence: 99%

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Seshadri

Gléhen

2016

Indian J Surg Oncol

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Peritoneal metastasis, either synchronous or metachronous, is commonly seen in gastric cancer. It is associated with a poor prognosis, with a median survival of less than one year. The outcomes are not significantly improved by the use of systemic chemotherapy. We review the relevant literature on the role of HIPEC in gastric cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used in three situations in gastric cancer. Besides its role as a definitive treatment in patients with established peritoneal metastasis (PM), it has been used as a prophylaxis against peritoneal recurrence after curative surgery and also as a palliative treatment in advanced peritoneal metastasis with intractable ascites. While prophylactic HIPEC has been shown to reduce peritoneal recurrence and improve survival in many randomised trials, palliative HIPEC can reduce the need for frequent paracentesis. Although CRS with HIPEC has shown promise in increasing the survival of selected patients with established PM from gastric cancer, larger studies are needed before this can be accepted as a standard of care.

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Hyperthermo‐chemotherapy combined with cytoreductive surgery for the treatment of gastric cancer with peritoneal dissemination

Cited by 131 publications

References 12 publications

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Surgical treatment of disseminated peritoneal metastases from urological cancer: results from a prospective study

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

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