A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent

Abstract 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 r...

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Bibliographic Details
Published in:	European journal of surgical oncology Vol. 42; no. 8; pp. 1123 - 1131
Main Authors:	Yonemura, Yutaka, MD., PhD, Canbay, Emel, Li, Yan, Coccolini, Federico, Glehen, Oliver, Sugarbaker, Paul H, Morris, David, Moran, Brendan, Gonzaletz-Moreno, Santiago, Deraco, Marcello, Piso, Pompilliu, Elias, Dominique, Batlett, David, Ishibashi, Haruaki, Mizumoto, Akiyoshi, Verwaal, Vic, Mahtem, Haile
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-08-2016
Subjects:	Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cisplatin - administration & dosage Cytoreduction Surgical Procedures - methods Drug Combinations Gastric cancer Hematology, Oncology and Palliative Medicine HIPEC Humans Hyperthermia, Induced - methods Infusions, Parenteral Multivariate Analysis Neoadjuvant Therapy NIPS Oxonic Acid - administration & dosage Peritoneal metastases Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Peritonectomy Peritoneum - surgery Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Taxoids - administration & dosage Tegafur - administration & dosage peritonectomy NIPS gastric cancer HIPEC peritoneal metastasis Peritonectomy Gastric cancer Peritoneal metastases
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Summary:	Abstract 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 cutoff 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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0748-7983 1532-2157 1532-2157
DOI:	10.1016/j.ejso.2016.03.016