Cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) for gastric cancer peritoneal metastases- the early experience of the first Gastric HIPEC centre in the British Isles.

2021 ◽  
Vol 47 (2) ◽  
pp. e6-e7
Author(s):  
Paul Healy ◽  
Brian Bird ◽  
Conor Shields ◽  
John Conneely ◽  
Gerry McEntee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Early Experience ◽  
Peritoneal Metastases ◽  
British Isles ◽  
Heated Intraperitoneal Chemotherapy

scholarly journals AB194. Cytoreductive surgery and heated intraperitoneal chemotherapy for gastric cancer peritoneal metastases

2020 ◽  
Vol 4 ◽  
pp. AB194-AB194
Author(s):  
Ciara Conaty ◽  
Prabir Brouha ◽  
Faraz Khan ◽  
Nisha Jagasia ◽  
Conor Shields ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastases ◽  
Heated Intraperitoneal Chemotherapy

Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Metastases (CYTO-CHIP study): A Propensity Score Analysis

2019 ◽  
Vol 37 (23) ◽  
pp. 2028-2040 ◽  
Author(s):  
Pierre-Emmanuel Bonnot ◽  
Guillaume Piessen ◽  
Vahan Kepenekian ◽  
Evelyne Decullier ◽  
Marc Pocard ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Peritoneal Metastases ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Peritoneal Cancer

PURPOSE Gastric cancer (GC) with peritoneal metastases (PMs) is a poor prognostic evolution. Cytoreductive surgery (CRS) yields promising results, but the impact of hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. Here we aimed to compare outcomes between CRS-HIPEC versus CRS alone (CRSa) among patients with PMs from GC. PATIENTS AND METHODS From prospective databases, we identified 277 patients with PMs from GC who were treated with complete CRS with curative intent (no residual nodules > 2.5 mm) at 19 French centers from 1989 to 2014. Of these patients, 180 underwent CRS-HIPEC and 97 CRSa. Tumor burden was assessed using the peritoneal cancer index. A Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) based on propensity score was used to assess the effect of HIPEC and account for confounding factors. RESULTS After IPTW adjustment, the groups were similar, except that median peritoneal cancer index remained higher in the CRS-HIPEC group (6 v 2; P = .003). CRS-HIPEC improved overall survival (OS) in both crude and IPTW models. Upon IPTW analysis, in CRS-HIPEC and CRSa groups, median OS was 18.8 versus 12.1 months, 3- and 5-year OS rates were 26.21% and 19.87% versus 10.82% and 6.43% (adjusted hazard ratio, 0.60; 95% CI, 0.42 to 0.86; P = .005), and 3- and 5-year recurrence-free survival rates were 20.40% and 17.05% versus 5.87% and 3.76% ( P = .001), respectively; the groups did not differ regarding 90-day mortality (7.4% v 10.1%, respectively; P = .820) or major complication rate (53.7% v 55.3%, respectively; P = .496). CONCLUSION Compared with CRSa, CRS-HIPEC improved OS and recurrence-free survival, without additional morbidity or mortality. When complete CRS is possible, CRS-HIPEC may be considered a valuable therapy for strictly selected patients with limited PMs from GC.

scholarly journals Which patient is going to benefit from surgical cytoreduction with intraperitoneal chemotherapy (for manifest peritoneal metastases)?

2017 ◽  
Vol 30 (4) ◽  
pp. 207-210
Author(s):  
Sebastian Blaj ◽  
Pompiliu Piso
Keyword(s):  
Gastric Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Multimodal Therapy ◽  
Survival Rates ◽  
Peritoneal Metastases ◽  
Oncological Surgery ◽  
Positive Expression ◽  
Multimodal Therapy Concept ◽  
Her 2

Abstract The gastric cancer with peritoneal metastases still represents a serious problem in the oncological surgery, whereas the peritoneal metastases arising from colorectal cancer can be successfully treated using a multimodal therapy concept consisting of systemic chemotherapy, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. The best survival rates in patients suffering from peritoneal metastases of gastric cancer have been reported by the ToGa trial, in patients with HER-2 positive expression who received standard chemotherapy and trastuzumab. Cytoreductive surgery and HIPEC are increasingly wining a place in the multimodal therapy of gastric cancer with peritoneal metastases, the criteria for such an aggressive therapy are strict and the operability needs to be previously assessed by laparoscopic exploration. Interesting new data are awaited from the German GASTRIPEC study and from the French GASTRICHIP study.

Prognosis of poorly cohesive gastric cancer after complete cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (CYTO-CHIP study)

2021 ◽  
Author(s):  
P E Bonnot ◽  
A Lintis ◽  
F Mercier ◽  
N Benzerdjeb ◽  
G Passot ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Group Versus ◽  
Clinicopathological Characteristics ◽  
Peritoneal Metastases ◽  
Peritoneal Cancer ◽  
The Impact

Abstract Background The incidence of gastric poorly cohesive carcinoma (PCC) is increasing. The prognosis for patients with peritoneal metastases remains poor and the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is controversial. The aim was to clarify the impact of gastric PCC with peritoneal metastases treated by CRS with or without HIPEC. Methods All patients with peritoneal metastases from gastric cancer treated with CRS with or without HIPEC, in 19 French centres, between 1989 and 2014, were identified from institutional databases. Clinicopathological characteristics and outcomes were compared between PCC and non-PCC subtypes, and the possible benefit of HIPEC was assessed. Results In total, 277 patients were included (188 PCC, 89 non-PCC). HIPEC was performed in 180 of 277 patients (65 per cent), including 124 of 188 with PCC (66 per cent). Median overall survival (OS) was 14.7 (95 per cent c.i. 12.7 to 17.3) months in the PCC group versus 21.2 (14.7 to 36.4) months in the non-PCC group (P < 0.001). In multivariable analyses, PCC (hazard ratio (HR) 1.51, 95 per cent c.i. 1.01 to 2.25; P = 0.044) was associated with poorer OS, as were pN3, Peritoneal Cancer Index (PCI), and resection with a completeness of cytoreduction score of 1, whereas HIPEC was associated with improved OS (HR 0.52; P < 0.001). The benefit of CRS-HIPEC over CRS alone was consistent, irrespective of histology, with a median OS of 16.7 versus 11.3 months (HR 0.60, 0.39 to 0.92; P = 0.018) in the PCC group, and 34.5 versus 14.3 months (HR 0.43, 0.25 to 0.75; P = 0.003) in the non-PCC group. Non-PCC and HIPEC were independently associated with improved recurrence-free survival and fewer peritoneal recurrences. In patients who underwent HIPEC, PCI values of below 7 and less than 13 were predictive of OS in PCC and non-PCC populations respectively. Conclusion In selected patients, CRS-HIPEC offers acceptable outcomes among those with gastric PCC and long survival for patients without PCC.

Sign in / Sign up

Export Citation Format

Share Document