Multidisciplinary therapy for treatment of patients with peritoneal carcinomatosis from gastric cancer

Yonemura, Yutaka; Elnemr, Ayman; Endou, Yoshio; Hirano, Minoru; Mizumoto, Akiyoshi; Takao, Nobuyuki; Ichinose, Masumi; Miura, Masahiro; Li, Yan

doi:10.4251/wjgo.v2.i2.85

Cited by 122 publications

(113 citation statements)

References 48 publications

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“…A positive peritoneal lavage cytology also predisposes to peritoneal recurrence. Upto 80 % of patients with a positive cytology (Cy+/P0) have a peritoneal recurrence after a curative gastrectomy compared to 45 % of patients with a negative cytology (Cy−/P0) [34]. The 5-year survival of these patients (Cy+/P0) treated with surgery and adjuvant systemic chemotherapy is only around 2 %, similar to those with established PM [35,36].…”

Section: Hipec For Prevention Of Peritoneal Recurrencementioning

confidence: 94%

“…However, CRS & HIPEC for PM from gastric cancer seems to be less effective when compared to other peritoneal surface malignancies, especially colorectal PM [28,67]. Nearly 50-58 % patients still develop recurrence [34,56,68] and 27-79 % patients die due to peritoneal recurrence [56,61]. Moreover, the procedure may be associated with a considerable morbidity and mortality.…”

Section: Nipsmentioning

confidence: 99%

“…The extent of peritoneal carcinomatosis is another important prognostic factor for the success of HIPEC, especially in patients who undergo a complete cytoreduction, and the most commonly used score to assess it is the peritoneal carcinomatosis index (PCI). Yonemura et al reported complete cytoreduction in 86 % of patients if the PCI score was ≤6 compared to 7 % if the PCI score was >13 [34]. A multicentre European study reported that in patients who had a complete cytoreduction, the PCI score was the only independent factor predicting survival, with no patient surviving beyond 6 months and 3 years if PCI was >19 and >12 respectively [59].…”

Section: Nipsmentioning

confidence: 99%

“…The bidirectional / neoadjuvant intraperitoneal and systemic chemotherapy (BIPSC/NIPS), introduced by Yonemura et al [64] is a treatment schedule that aims at stage reduction, eradication of IFCC, and an increase in the incidence of complete cytoreduction [34]. The rationale of this method is to reduce tumour burden before surgery with NIPS, reduce macroscopic and microscopic PM with CRS & HIPEC and finally eradicate residual intraperitoneal cancer cells before the development of adhesions using EPIC.…”

Section: Nipsmentioning

confidence: 99%

“…The rationale of this method is to reduce tumour burden before surgery with NIPS, reduce macroscopic and microscopic PM with CRS & HIPEC and finally eradicate residual intraperitoneal cancer cells before the development of adhesions using EPIC. By simultaneously administering intravenous and intraperitoneal chemotherapy, the cancer cells are attacked both from the peritoneal cavity and from subperitoneal blood vessels [34,64].…”

Section: Nipsmentioning

confidence: 99%

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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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Section: Hipec For Prevention Of Peritoneal Recurrencementioning

confidence: 94%

Section: Nipsmentioning

confidence: 99%

Section: Nipsmentioning

confidence: 99%

Section: Nipsmentioning

confidence: 99%

Section: Nipsmentioning

confidence: 99%

See 3 more Smart Citations

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Seshadri

Gléhen

2016

Indian J Surg Oncol

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Tumor characteristics and clinical outcome of peritoneal metastasis of gastric origin treated with a hyperthermic intraperitoneal chemotherapy procedure in the PERISCOPE I trial

Koemans

Kaaij

Wassenaar

et al. 2021

Journal of Surgical Oncology

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Introduction The PERISCOPE I (Treatment of PERItoneal dissemination in Stomach Cancer patients with cytOreductive surgery and hyPErthermic intraperitoneal chemotherapy) study was conducted to investigate the safety and feasibility of hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients with limited peritoneal dissemination. In this study, tumor characteristics and clinical outcome of the patients treated in the PERISCOPE I trial were investigated. Methods Patients who had undergone the full study protocol were selected; that is, preoperative systemic chemotherapy, followed by a surgical procedure consisting of a (sub)total gastrectomy, cytoreductive surgery, and HIPEC with oxaliplatin (460 mg/m2) and docetaxel (in escalating doses). Results Twenty‐five PERISCOPE I patients underwent the full study protocol. Most patients had an ypT3‐4 tumor (96%) and the diffuse‐type histology was predominant (64%). Seven patients (28%) had a microscopically irradical (R1) resection. In all patients, a complete cytoreduction was achieved. Median follow‐up was 37 (95% confidence interval [CI]: 34–39) months. Disease recurrence was detected in 17 patients (68%). Median disease‐free and overall survival were 12 and 15 months, respectively. Conclusion In this series of gastric cancer patients with limited peritoneal dissemination who underwent HIPEC surgery, unfavorable tumor characteristics were common. Survival might be encouraging but disease recurrence was frequent. The efficacy of an HIPEC procedure in improving prognosis is currently being investigated in the PERISCOPE II trial.

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Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease

Khan

Johnston

2022

Journal of Surgical Oncology

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Gastric cancer (GC) is an aggressive malignancy with a high burden of peritoneal disease. Evidence regarding the use of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to improve outcomes has been growing. However, given multiple limitations, there remains a lack of international consensus regarding the optimal treatment paradigm. This review article discusses the burden of peritoneal disease in GC patients and the role of CRS + HIPEC in all treatment intents—curative, prophylactic, and palliative.

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Multidisciplinary therapy for treatment of patients with peritoneal carcinomatosis from gastric cancer

Cited by 122 publications

References 48 publications

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Tumor characteristics and clinical outcome of peritoneal metastasis of gastric origin treated with a hyperthermic intraperitoneal chemotherapy procedure in the PERISCOPE I trial

Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease

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