Benefits of Surgery After Neoadjuvant Intraperitoneal and Systemic Chemotherapy for Gastric Cancer Patients With Peritoneal Metastasis: A Meta-Analysis

Abstract Background There is no currently available treatment for peritoneal metastasis of gastric cancer. This phase II study aimed to evaluate the efficacy and safety of neoadjuvant systemic chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) for the treatment of these patients. Methods Neoadjuvant chemotherapy comprised two cycles of HIPEC and four cycles of S-1 plus paclitaxel. HIPEC was administered intraperitoneally with paclitaxel (75 mg/m2). For systemic chemotherapy, paclitaxel was administered intravenously(150 mg/m2) on day 1, and S-1 was administered orally(80 mg/m2/day)on days 1–14 of a 3-week cycle. Another two cycles of HIPEC and four cycles of S-1 plus paclitaxel were administered after second diagnostic staging laparoscopy or CRS. The primary endpoints were treatment efficiency and safety; the secondary endpoint was 3-year overall survival (OS). Results A total of 40 patients were enrolled and 38 patients have been analyzed. Of these, 18 (47.4%) patients received neoadjuvant systemic chemotherapy, HIPEC and CRS (conversion therapy group), while 20 patients received only chemotherapy and HIPEC (palliative chemotherapy group). Median OS was markedly improved in the conversion therapy group (21.1 months, 95% confidence interval [CI] 16.7–25.6 months) in comparison with the palliative chemotherapy group(10.8 months, 95%CI 7.3–14.2 months, p = 0.002). After neoadjuvant systemic chemotherapy and HIPEC, a second laparoscopic exploration was performed, and the prognosis of patients with low peritoneal cancer index (PCI) (PCI < 6) was significantly better than that of patients with high PCI (PCI ≥ 6)(20.1 vs.11.3 months, p = 0.006). Conclusion Neoadjuvant systemic chemotherapy and HIPEC combined with CRS is safe and feasible, and could potentially improve the prognosis of gastric cancer patients with limited peritoneal metastasis. However, further clinical trials are still warranted. Trial registration This study has been registered with ClinicalTrials.gov as NCT02549911. Trial registration date: 15/09/2015.

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Complications in advanced or recurrent gastric cancer patients with peritoneal metastasis during and after palliative systemic chemotherapy

Molecular and Clinical Oncology ◽

10.3892/mco.2015.510 ◽

2015 ◽

Vol 3 (3) ◽

pp. 539-542 ◽

Cited By ~ 9

Author(s):

YASUO HAMAMOTO

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Peritoneal Metastasis ◽

Systemic Chemotherapy ◽

Recurrent Gastric Cancer ◽

Gastric Cancer Patients ◽

Palliative Systemic Chemotherapy

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Prognostic significance of malignant ascites in gastric cancer patients with peritoneal metastasis: A systemic review and meta-analysis

World Journal of Clinical Cases ◽

10.12998/wjcc.v7.i20.3247 ◽

2019 ◽

Vol 7 (20) ◽

pp. 3247-3258 ◽

Cited By ~ 2

Author(s):

Ling-Nan Zheng ◽

Feng Wen ◽

Ping Xu ◽

Shuang Zhang

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Peritoneal Metastasis ◽

Meta Analysis ◽

Prognostic Significance ◽

Malignant Ascites ◽

Systemic Review ◽

Gastric Cancer Patients

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Neoadjuvant systemic and hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery for gastric cancer patients with limited peritoneal metastasis: a prospective cohort study

10.21203/rs.3.rs-46063/v2 ◽

2020 ◽

Author(s):

Pengfei Yu ◽

Zeyao Ye ◽

Gaiguo Dai ◽

Yanqiang Zhang ◽

Ling Huang ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Intraperitoneal Chemotherapy ◽

Peritoneal Metastasis ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Systemic Chemotherapy ◽

Palliative Chemotherapy ◽

Therapy Group ◽

Conversion Therapy ◽

Gastric Cancer Patients

Abstract Background: There is no currently available treatment for peritoneal metastasis of gastric cancer. This phase II study aimed to evaluate the efficacy and safety of neoadjuvant systemic chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) for the treatment of these patients. Methods: Neoadjuvant chemotherapy comprised two cycles of HIPEC and four cycles of S-1 plus paclitaxel. HIPEC was administered intraperitoneally with paclitaxel (75 mg/m2). For systemic chemotherapy, paclitaxel was administered intravenously(150 mg/m2) on day 1，and S-1 was administered orally（80 mg/m2/day）on days 1-14 of a 3-week cycle. Another two cycles of HIPEC and four cycles of S-1 plus paclitaxel were administered after second diagnostic staging laparoscopy or CRS. The primary endpoint was treatment efficiency and safety; the secondary endpoint was 3-year overall survival (OS). Results: A total of 40 patients were enrolled and 38 patients have been analyzed. Of these, 18 (47.4%) patients received neoadjuvant systemic chemotherapy, HIPEC and CRS (conversion therapy group), while 20 patients received only chemotherapy and HIPEC (palliative chemotherapy group). Median OS was markedly improved in the conversion therapy group (21.1 months, 95% confidence interval [CI] 16.7-25.6 months) in comparison with the palliative chemotherapy group(10.8 months, 95%CI 7.3-14.2 months, p=0.002). After neoadjuvant systemic chemotherapy and HIPEC, a second laparoscopic exploration was performed, and the prognosis of patients with low peritoneal cancer index (PCI) (PCI < 6) was significantly better than that of patients with high PCI (PCI≥6)(20.1 vs.11.3 months, p=0.006). Conclusion: Neoadjuvant systemic chemotherapy and HIPEC combined with CRS was safe and feasible, and could potentially improve the prognosis of gastric cancer patients with limited peritoneal metastasis. However, further clinical trials are still warranted.

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Neoadjuvant systemic and hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery for gastric cancer patients with limited peritoneal metastasis: a prospective cohort study

10.21203/rs.3.rs-46063/v1 ◽

2020 ◽

Author(s):

Pengfei Yu ◽

Zeyao Ye ◽

Gaiguo Dai ◽

Yanqiang Zhang ◽

Ling Huang ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Intraperitoneal Chemotherapy ◽

Peritoneal Metastasis ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Systemic Chemotherapy ◽

Palliative Chemotherapy ◽

Therapy Group ◽

Conversion Therapy ◽

Gastric Cancer Patients

Abstract Background There is no currently available treatment for peritoneal metastasis of gastric cancer. This phase II study aimed to evaluate the efficacy and safety of neoadjuvant systemic chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) for the treatment of these patients. Methods Neoadjuvant chemotherapy comprised two cycles of HIPEC and four cycles of S-1 plus paclitaxel. HIPEC was administered intraperitoneally with paclitaxel (75 mg/m2). For systemic chemotherapy, paclitaxel was administered intravenously(150 mg/m2) on day 1,and S-1 was administered orally(80 mg/m2/day)on days 1–14 of a 3-week cycle. Another two cycles of HIPEC and four cycles of S-1 plus paclitaxel were administered after second diagnostic staging laparoscopy or CRS. The primary endpoint was treatment efficiency and safety; the secondary endpoint was 3-year overall survival (OS). Results A total of 40 patients were enrolled and 38 patients have been analyzed. Of these, 18 (47.4%) patients received neoadjuvant systemic chemotherapy, HIPEC and CRS (conversion therapy group), while 20 patients received only chemotherapy and HIPEC (palliative chemotherapy group). Median OS was markedly improved in the conversion therapy group (21.1 months, 95% confidence interval [CI] 16.7–25.6 months) in comparison with the palliative chemotherapy group(10.8 months, 95%CI 7.3–14.2 months, p = 0.002). After neoadjuvant systemic chemotherapy and HIPEC, a second laparoscopic exploration was performed, and the prognosis of patients with low peritoneal cancer index (PCI) (PCI < 6) was significantly better than that of patients with high PCI (PCI ≥ 6)(20.1 vs.11.3 months, p = 0.006). Conclusion Neoadjuvant systemic chemotherapy and HIPEC combined with CRS was safe and feasible, and could potentially improve the prognosis of gastric cancer patients with limited peritoneal metastasis. However, further clinical trials are still warranted. Trial registration: This study is registered with ClinicalTrials.gov as NCT02549911, registered on 15 September 2015.

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Does high body mass index negatively affect the surgical outcome and long-term survival of gastric cancer patients who underwent gastrectomy: A systematic review and meta-analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.09.007 ◽

2018 ◽

Vol 44 (12) ◽

pp. 1971-1981 ◽

Cited By ~ 7

Author(s):

Bochao Zhao ◽

Jingting Zhang ◽

Di Mei ◽

Rui Luo ◽

Huiwen Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Body Mass Index ◽

Cancer Patients ◽

Surgical Outcome ◽

Meta Analysis ◽

High Body Mass Index ◽

Term Survival ◽

Gastric Cancer Patients

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Survival Benefit of Traditional Chinese Herbal Medicine (A Herbal Formula for Invigorating Spleen) in Gastric Cancer Patients with Peritoneal Metastasis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/625493 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Lu Zhao ◽

Ai-Guang Zhao ◽

Gang Zhao ◽

Yan Xu ◽

Xiao-Hong Zhu ◽

...

Keyword(s):

Gastric Cancer ◽

Herbal Medicine ◽

Cancer Patients ◽

Chinese Herbal Medicine ◽

Peritoneal Metastasis ◽

Herbal Formula ◽

First Line ◽

Traditional Chinese Herbal Medicine ◽

Chinese Herbal ◽

Gastric Cancer Patients

Objective.We evaluated the efficiency of traditional Chinese herbal medicine (a compound herbal formula for invigorating spleen) as a complementary and alternative therapy for gastric cancer patients with peritoneal metastasis.Methods.Between 2001 and 2012, 93 gastric cancer patients with peritoneal metastasis were enrolled in this study. The effect of traditional Chinese herbal medicine on their long-term outcome was investigated. Kaplan-Meier method was used to assess the difference in survival time, and Cox proportional hazards regression analysis was performed to identify independent prognostic factors.Result.First-line palliative chemotherapy plus traditional Chinese herbal medicine was performed in 47 patients and the other 46 patients received chemotherapy alone. The overall survival was different between patients with and without traditional Chinese herbal medicine (12.0 versus 10.5 months;P=0.046). According to the Cox proportional hazard model, first-line chemotherapy cycle (hazards ratio [HR] = 0.527; 95% CI = 0.323~0.860) and TCHM (hazards ratio [HR] = 0.644; 95% CI = 0.481~0.992) were selected as independent prognostic factors for survival.Conclusion.The results suggest that traditional Chinese herbal medicine could improve the prognosis of the gastric cancer patients with peritoneal metastasis.

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