Treatment of Peritoneal Carcinomatosis in Gastric Cancers

Brigand, Cécile; Arvieux, C.; Gilly, François-Noël; Gléhen, Olivier

doi:10.1159/000083600

Cited by 26 publications

(14 citation statements)

References 88 publications

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“…In this regard, one should consider that a real significant benefit of actual chemotherapy agents in controlling peritoneal disease from GC has not been demonstrated [21,23].…”

Section: Discussionmentioning

confidence: 99%

Gastric linitis plastica: which role for surgical resection?

et al. 2011

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Background The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence. Methods Results of surgery were analyzed in 102 patients with GLP. Results Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases. R2 resection was carried out in 20 patients and R1 in 12 patients, while the resection was considered potentially curative (R0) in 28 (27.5%). Overall, the median (95% confidence interval [CI]) survival time was 5.7 (3.7-7.5) months, with none of the patients alive at the end date of the study. For R0 patients the median (95% CI) survival time was 15.8 (11-20.7) months. The great majority of recurrences were intra-abdominal (peritoneal and/or locoregional), with a systemic component of the relapse that was rarely observed (5 cases). Conclusions After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease. Specifically designed multimodality treatment protocols should be tested in this setting.

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“…In this regard, one should consider that a real significant benefit of actual chemotherapy agents in controlling peritoneal disease from GC has not been demonstrated [21,23].…”

Section: Discussionmentioning

confidence: 99%

Gastric linitis plastica: which role for surgical resection?

et al. 2011

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“…Peritoneal dissemination is a common cause of failure after curative treatment for gastric cancer. Peritoneal recurrence occurs in 17% of patients undergoing resection with curative intent and is associated with a dismal survival [ 5 , 6 ]. Due to the frequent occurrence and the strong prognostic relevance of peritoneal metastases, detection of free intraperitoneal tumor cells (FITC) has been suggested as a prognostic and predictive biomarker in gastric cancer patients [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Free intraperitoneal tumor cells and outcome in gastric cancer patients: a systematic review and meta-analysis

et al. 2015

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PurposeDespite continuously improving therapies, gastric cancer still shows poor survival in locally advanced stages with local recurrence rates of up to 50% and peritoneal recurrence rates of 17% after curative surgery. We performed a systematic review with meta-analyses to clarify whether positive intraperitoneal cytology (IPC) indicates a high risk of disease recurrence and poor overall survival in gastric cancer.MethodsMultiple databases were searched in December 2014 to identify studies on the prognostic significance of positive intraperitoneal cytology in gastric cancer, including: Medline, Biosis, Science Citation Index, Embase, CCMed and publisher databases. Hazard ratios (HR) and associated 95% confidence intervals (CI) were extracted from the identified studies. A meta-analysis was performed using a random-effects model on overall survival, disease-free survival and peritoneal recurrence free survival.ResultsA total of 64 studies with a cumulative sample size of 12,883 patients were included. Cytology, quantitative real time polymerase chain reaction (PCR) or both were performed in 35; 21 and 8 studies, respectively. Meta analyses revealed free intraperitoneal tumor cells (FITC) to be associated with poor overall survival in univariate (HR 3.27; 95% CI 2.82 - 3.78]) and multivariate (HR 2.45; 95% CI 2.04 - 2.94) analysis and poor peritoneal recurrence free survival in univariate (4.15; 95% CI 3.10 - 5.57) and multivariate (3.09; 95% CI 2.02 - 4.71) analysis. Subgroup analysis showed this effect to be independent of the detection method, Western or Asian origin or the time of publication.ConclusionsFITC oder positive peritoneal cytology is associated with poor survival and increased peritoneal recurrence in gastric cancer.

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“…(3) One of the problems with this type of therapy is the limited delivery of systemically administered drugs to the peritoneal cavity. (4) Intraperitoneal chemotherapy has been shown to be safe and effective in ovarian cancer (5)(6)(7) and is expected to provide a breakthrough in the treatment of gastric cancer with peritoneal dissemination. (8)(9)(10) However, in addition to the intraperitoneal administration of drugs, it is necessary to develop new strategies for the treatment of gastric cancer to achieve better results.…”

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confidence: 99%

Antitumor effect and pharmacokinetics of intraperitoneal NK105, a nanomicellar paclitaxel formulation for peritoneal dissemination

et al. 2012

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The intraperitoneal administration of paclitaxel has been shown to be a promising treatment strategy for peritoneal malignancy. The present study evaluated the effects of intraperitoneal administration of NK105, a paclitaxel-incorporating micellar nanoparticle, which has been shown to have a remarkable effect in a mouse model of gastric cancer. Intraperitoneal NK105 significantly reduced peritoneal tumors in vivo compared with the conventional paclitaxel formulation of paclitaxel solubilized in Cremophor EL and ethanol (PTX-Cre). Moreover, intraperitoneal NK105 significantly reduced the size of subcutaneously inoculated tumors, whereas no such effect was seen with PTX-Cre. Similar systemic toxic effects were observed following the intraperitoneal administration of both NK105 and PTX-Cre. Although NK105 disappeared rapidly almost within a day from the peritoneal cavity, the paclitaxel concentration in peritoneal nodules 4 h after intraperitoneal administration was significantly higher in the NK105 group than in the PTX-Cre group (P < 0.05), whereas there were no significant differences in liver paclitaxel concentrations between the two groups. We also evaluated the pharmacokinetics following intraperitoneal administration of NK105 and PTX-Cre. Serum paclitaxel concentrations 6, 12, 24, and 48 h after the intraperitoneal administration of the drugs were significantly higher in the NK105 than the PTX-Cre group. Furthermore, the peak serum concentration was higher in the NK105 than PTX-Cre group (24 100 ± 3560 vs 108 ± 25 ng/mL, respectively; P < 0.001), as was the area under the concentration-time curve from 0 to 48 h (191 000 ± 32 100 vs 1500 ± 108 ngÁh/mL, respectively; P < 0.001). Therefore, intraperitoneal chemotherapy with nanoparticulate paclitaxel NK105 may offer a novel treatment strategy for improving drug delivery in gastric cancer with peritoneal dissemination because of enhanced drug penetration into peritoneal nodules and its prolonged presence in the systemic circulation. (Cancer Sci 2012; 103: 1304-1310 G astric cancer is the fourth leading cause of cancer-related deaths worldwide, and peritoneal dissemination is the most frequent and life-threatening form of metastasis and recurrence in patients with gastric cancer.(1,2) The current systemic chemotherapy regimens for gastric cancer have not achieved satisfactory results, particularly in the treatment of peritoneal dissemination.(3) One of the problems with this type of therapy is the limited delivery of systemically administered drugs to the peritoneal cavity.(4) Intraperitoneal chemotherapy has been shown to be safe and effective in ovarian cancer (5)(6)(7) and is expected to provide a breakthrough in the treatment of gastric cancer with peritoneal dissemination.(8-10) However, in addition to the intraperitoneal administration of drugs, it is necessary to develop new strategies for the treatment of gastric cancer to achieve better results. Research into drug delivery systems (DDS) is ongoing and is mostly aimed at improving the penetration of drugs...

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Treatment of Peritoneal Carcinomatosis in Gastric Cancers

Cited by 26 publications

References 88 publications

Gastric linitis plastica: which role for surgical resection?

Gastric linitis plastica: which role for surgical resection?

Free intraperitoneal tumor cells and outcome in gastric cancer patients: a systematic review and meta-analysis

Antitumor effect and pharmacokinetics of intraperitoneal NK105, a nanomicellar paclitaxel formulation for peritoneal dissemination

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