Surgical treatment for peritoneal carcinomatosis from gastric cancer

Yonemura, Yutaka; Endou, Yoshio; Sasaki, Takuma; Hirano, Masamitu; Mizumoto, Akiyoshi; Matsuda, Takayuki; Takao, Nobuyuki; Ichinose, Masumi; Miura, Masahiro; Li, Y.

doi:10.1016/j.ejso.2010.09.006

Cited by 109 publications

(80 citation statements)

References 55 publications

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“…In contrast, PFCCs could be efficiently treated by the intraperitoneal chemotherapy, because high loco-regional intensity can be obtained by the intraperitoneal chemotherapy. Yonemura et al (2010) reported that the positive cytology results became negative in 69% (47/68) of patients with PM from gastric cancer after six cycles of neoadjuvant intraperitoneal/systemic chemotherapy (NIPS). The present study demonstrated that the positive cytology changed to be negative in 16 (57.1%) of 28 patients after one session of LHIPEC.…”

Section: Discussionmentioning

confidence: 99%

Effects of Laparosopic Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Gastric Cancer

Yonemura¹,

Canbay²,

Sako³

et al. 2014

CCO

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Background: The purpose of this manuscript is to report the direct effects of hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer-patients with peritoneal metastasis (PM). Materials and Methods:Thirty-five patients with PM were enrolled, and were treated with neoadjuvant laparoscopic HIPEC (LHIPEC). LHIPEC was performed at 42 to 43 centigrade for 60 minutes adding 3 liter of saline plus 12.5mg/m2 of Mitomycin C with Cisplatin (50mg/m 2 ). Second session of LHIPEC was done one month after the first LHIPEC in all cases. At the second session of LHIPEC, ascites volume, peritoneal cytology and peritoneal cancer index (PCI) were examined again.Results: Intraoperative complications of bowel injury were experienced in one and three at 1 st and 2 nd session of laparoscopy, respectively. There was no mortality after LHIPEC. Ascites was completely disappeared in 17 of 34 patients at the second session of laparoscopy. PFCCs had been detected in 28 (80.0%) patients at the 1 st session, and the positive cytology changed to be negative in 16 (57.1%) of 28 patients at the second session. PCI at the 2 nd session (12.5 ± 10.5) was significantly lower than that at the 1 st session (16.8 ± 9.6) (P=0.023). PCI levels at the 2 nd session changed to be 0 in 6 patients. Conclusion:This new method is not only a safe and convenient method for predicting feasibility of complete cytoredution, but also an effective treatment to control malignant ascites and to eradicate PFCCs before cytoreductive surgery. Furthermore, LHIPEC can reduce PCI levels.

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Section: Discussionmentioning

confidence: 99%

Effects of Laparosopic Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Gastric Cancer

Yonemura¹,

Canbay²,

Sako³

et al. 2014

CCO

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“…Indeed, in a large phase III clinical trial in colorectal cancer spread to the peritoneum, HIPEC and CRS extended median survival from 12.6 to 22.3 months (P=0.032) (17). Likewise, small trials have indicated an association with prolonged survival when applying this technique to AGC with PC (23)(24)(25).…”

Section: Crs + Hipec Clinical Experience: Promising Resultsmentioning

confidence: 99%

A critical analysis of the cytoreductive surgery with hyperthermic intraperitoneal chemotherapy combo in the clinical management of advanced gastric cancer: an effective multimodality approach with scope for improvement

Beeharry

Yao

et al. 2016

Transl. Gastroenterol. Hepatol.

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Peritoneal carcinomatosis (PC) is manifested in up to 40% of gastric cancer (GC) patients, after which their 5-year survival drops to less than 5%. The currently most acceptable treatment option for advanced GC (AGC) is systemic chemo and radio therapies with however generally very unsatisfying results and this led to a resurgence of interest in regional therapies like cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Small trials have indicated an association with prolonged survival when applying this technique to AGC manifesting with PC. High procedure-related morbidity and mortality associated with the CRS-HIPEC approach have however brought by a polemic on the merits of the latter: with the advent of regulatory approval of more effective as well as novel, more personalized treatment options in AGC, along with advances in tailoring investigational agents specifically for peritoneal delivery, there clearly is a need to outline the appropriate role of CRS-HIPEC in this disease.In a clear objective to improve the therapeutic efficiency of HIPEC, there have been immense developments in the technical aspects of this technology including the use of nanotechnology in more precise drug delivery systems (DDS) or choice of more efficient drugs such as gene-target technology, laparoscopy and so on. Henceforth, in this review, we will be highlighting the past and current status of the CRS + HIPEC procedure, shedding light on the pros and cons in order to boost up the efficiency of this multimodality approach.

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“…Peritoneal metastasis frequently occurs in patients with recurrent gastrointestinal malignancies (19). The most serious condition that may develop in peritoneal metastasis is PC, which has an extremely poor prognosis (6,20,21).…”

Section: Discussionmentioning

confidence: 99%

Hyperthermic intraperitoneal perfusion chemotherapy and response evaluation in patients with gastric cancer and malignant ascites

et al. 2017

Oncology Letters

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Abstract. The present study describes the use of bidirectional chemotherapy in the treatment of patients with gastric cancer and peritoneal carcinomatosis (PC), using newly developed response criteria for the treatment of malignant ascites. In addition, the association between effusion response and survival was analyzed. Between June 2010 and May 2014, patients affected by malignant ascites secondary to unresectable PC of gastric origin were treated with a combination of systemic and loco-regional chemotherapy. Cisplatin (75 mg/m 2 ) at an inflow temperature of 43˚C was infused intraperitoneally, and docetaxel (75 mg/m 2 ) was infused simultaneously via a peripheral vein, on day 1 every 3 weeks. The primary endpoint was overall survival rate, and the secondary endpoint was efficacy against malignant ascites using new response criteria. In total, 41 patients were enrolled, the majority of whom received 6 cycles of intraperitoneal chemotherapy in combination with hyperthermia. The majority of patients exhibited clinical regression of ascites and relief of associated symptoms. Malignant ascites disappeared [complete response (CR)] or decreased by 50% [partial response (PR)] in 73.2% of patients. No mortalities associated with the procedures occurred. The median survival time was 8.6 months, and the 1-year survival rate was 24.4%. As these new response criteria for the treatment of malignant ascites were found to be feasible, bidirectional chemotherapy may be the preferred strategy for the treatment of gastric cancer with PC. The CR, PR and non-PR groups showed significant differences in overall survival, indicating that decreased effusion was associated with improved patient survival.

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Surgical treatment for peritoneal carcinomatosis from gastric cancer

Cited by 109 publications

References 55 publications

Effects of Laparosopic Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Gastric Cancer

Effects of Laparosopic Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Gastric Cancer

A critical analysis of the cytoreductive surgery with hyperthermic intraperitoneal chemotherapy combo in the clinical management of advanced gastric cancer: an effective multimodality approach with scope for improvement

Hyperthermic intraperitoneal perfusion chemotherapy and response evaluation in patients with gastric cancer and malignant ascites

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