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A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent
Kusatsu Gen Hosp, Kishiwada Tokushukai Hosp, Peritoneal Surface Malignancy Ctr, Kishiwada, Shiga, Japan.;NPO Support Peritoneal Surface Malignancy Treatme, Osaka 6008189, Japan..
NPO Support Peritoneal Surface Malignancy Treatme, Osaka 6008189, Japan..
Capital Med Univ, Beijin Shijitan Hosp, Dept Peritoneal Surface Oncol, Beijing 100038, Peoples R China..
Gen Surg Papa Giovanni XXIII Hosp, Bergamo, Italy..
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2016 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 42, no 8, 1123-1131 p.Article, review/survey (Refereed) Published
Abstract [en]

Recently, Peritoneal Surface Oncology Group International (PSOGI) developed a novel comprehensive treatment consisting of cytoreductive surgery (CRS) and perioperative chemotherapy (POC) for the treatment of peritoneal metastases (PM) from gastric cancer with curative intent. This article reviews the results of this treatment and verifies its indication. In this strategy, peritoneal cancer index (PCI) is determined by laparoscopy, and a peritoneal port is placed. Neoadjuvant bidirectional intraperitoneal/systemic chemotherapy (NIPS) is performed for 3 cycles, and then laparotomy is performed. Cytoreductive surgery with peritonectomy procedures and hyperthermic intraperitoneal chemoperfusion (HIPEC) are performed. Multivariate analyses showed that completeness of cytoreduction, pathologic response to NIPS and PCI level and cytologic status after NIPS, as independent prognostic factors. PCI less than cut-off level after NIPS, negative cytology after NIPS, and positive response to NIPS were identified as the indications for comprehensive treatment. Patients who hold these criteria should be considered as the candidates for CRS and HIPEC.

Place, publisher, year, edition, pages
2016. Vol. 42, no 8, 1123-1131 p.
Keyword [en]
Gastric cancer, Peritoneal metastases, HIPEC, Peritonectomy, NIPS
National Category
Cancer and Oncology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-306061DOI: 10.1016/j.ejso.2016.03.016ISI: 000383005000005PubMedID: 27160355OAI: oai:DiVA.org:uu-306061DiVA: diva2:1039692
Available from: 2016-10-25 Created: 2016-10-24 Last updated: 2016-10-25Bibliographically approved

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