Staging laparoscopy and neoadjuvant chemotherapy of biweekly docetaxel and S-1 for gastric cancer with peritoneal dissemination.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e14570-e14570
Author(s):  
Y. Kakeji ◽  
E. Oki ◽  
K. Yoshinaga ◽  
H. Saeki ◽  
E. Tokunaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Peritoneal Dissemination ◽  
Staging Laparoscopy

scholarly journals P-OGC36 Staging Laparoscopy in Oesophago-gastric cancers; A highly selective approach and its impact on patient outcome during COVID 19

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Paul Koroma ◽  
Madhu Chaudhury ◽  
S Ali Raza Shehrazi ◽  
Christopher Ball ◽  
Paul Turner ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Patient Outcome ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Advanced Disease ◽  
Staging Laparoscopy ◽  
Curative Surgery ◽  
Selective Approach ◽  
Significant Difference

Abstract Background Staging laparoscopy is performed in all Oesophago-gastric cancer patients suitable for radical treatment with tumour staged ≥T2 prior to neoadjuvant chemotherapy. In response to COVID 19 pandemic, on 25th March 2020, the joint statement issued by the Royal College of Surgeons and AUGIS advised all laparoscopic procedures should be avoided due to the risk of virus transmission associated with aerosol-generating procedures. In accordance with the guidance, a more selective approach on who underwent a staging laparoscopy was followed. This audit explores its impact on patient outcome comparing data from pre COVID period with the COVID period. Methods Retrospective and prospective data was collected for 24months on all OG cancer patients from 25th March2019 to 24th March2021. ‘Pre COVID’ period was defined as 25th March 2019 to 24th March 2020 and ‘COVID’ period was defined as 25th March 2020 to 24th March 2021. All patients with Oesophago-gastric cancer with MDT cancer staged ≥T2, suitable for neoadjuvant chemotherapy were included. Patients with tumour staged <T2 and or diagnosed with squamous cell carcinoma involving upper or middle third of oesophagus were excluded. Fishers Exact model using SPSS V24 was used to identify any statistically significant differences between the 2 groups. Results Pre-COVID Period: 80patients underwent staging laparoscopy. Of these, 9patients(11.6%) with tumour staged as ≥T3 were declined curative surgery due to advanced disease(n = 2), metastatic disease(n = 3) or both(n = 4). In total, 40patients underwent curative surgery and there were 0 open/close laparotomies. COVID Period: Of the 79patients suitable for staging laparoscopy, only 7patients(8.7%) underwent laparoscopy. Of these, 3patients(3.8%) with tumour staged as ≥T3 were declined curative surgery due to advanced disease(n = 2) and metastatic disease(n = 1). In total, 33patients underwent curative surgery and only 1patient had an open/close laparotomy due to a liver metastases. No statistically significant difference was found p = 0.0913 Conclusions Staging laparoscopy is a useful tool for accurate staging of Oesophago-gastric cancers. It helps avoid unnecessary open and close laparotomy due to advanced disease and also allows us to assess patient fitness to major surgery. During the pandemic, the number of staging laparoscopies performed declined significantly but with no statistically significant difference to patient outcome. Thus we conclude,  the COVID 19 pandemic has enabled us to have a selective approach to performing staging laparoscopy in Oesophago-gastric patients with advanced disease staged ≥T3 only.

S-1 and intraperitoneal and intravenous paclitaxel as neoadjuvant chemotherapy for gastric cancer with positive peritoneal cytology.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 142-142
Author(s):  
Y. Peng ◽  
M. Imano ◽  
H. Imamoto ◽  
K. Nishiki ◽  
Y. Nakamori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Survival Rates ◽  
Complete Response ◽  
Staging Laparoscopy ◽  
Peritoneal Cytology ◽  
Second Look ◽  
Progression Of Disease ◽  
Positive Peritoneal Cytology ◽  
Grade 3

142 Background: The prognosis of gastric cancer with positive peritoneal cytology is dismal. Standard treatments for these patients have not been established. The purpose of this study was to evaluate the safety and response of the regimen. Methods: Patients who were diagnosed with advanced gastric cancer between 2007 and 2010 underwent staging laparoscopy and received intraperitoneal paclitaxel when peritoneal cytology were positive and sequential systemic chemotherapy, S-1 combined with intravenous paclitaxel within 14 days after staging laparoscopy. Paclitaxel was administered intraperitoneally at 80 mg/m2. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest. Paclitaxel was administered intravenously at 50 mg/m2 on day 1 and day 8. After 2 courses of S-1 combined with paclitaxel were administered, clinical response was assessed by gastroendoscopy and computed tomography. Additional 2 or 3 courses were administered unless progression of disease was proved. Patients who achieved complete response (CR) or partial response (PR) and patients with stable disease (SD) underwent second-look laparoscopy following gastrectomy when peritoneal cytology turned negative. Results: 8 (7 male, 1 female) patients were enrolled: median age was 64 years (range 40-75). Of 8 patients, 1 patient achieved CR, and 5 PR. 2 patients showed progressive disease (PD). Grade 3 neutropenia occurred in 1 patient. 6 patients underwent second-look laparoscopy and peritoneal cytology turned negative in all 6 patients. Total or distal gastrectomy with lymphnode dissection was performed consecutively in 3 or 3 patients, respectively. Median follow-up duration was 775 days (range 187-1,028). No recurrence has not been observed, while the 1-year and 2-year survival rates of 14 patients with peritoneal cytology positive gastric cancer who have not received neoadjuvant chemotherapy were 58.3% and 33.3%, respectively. Conclusions: S-1, intraperitoneal and intravenous paclitaxel as neoadjuvant chemotherapy seems to be a effective strategy against gastric cancer with positive peritoneal cytology. No significant financial relationships to disclose.

Effectiveness and limitations of staging laparoscopy for peritoneal metastases in advanced gastric cancer from the results of JCOG0501: A randomized trial of gastrectomy with or without neoadjuvant chemotherapy for type 4 or large type 3 gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 9-9 ◽  
Author(s):  
Shinji Hato ◽  
Yoshiaki Iwasaki ◽  
Junki Mizusawa ◽  
Masanori Terashima ◽  
Hitoshi Katai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
False Negative ◽  
Peritoneal Metastases ◽  
Staging Laparoscopy ◽  
Phase Iii ◽  
Large Type ◽  
Study Results ◽  
Omental Bursa ◽  
Type 3

9 Background: In type 4 or large type 3 gastric cancer diagnosed as not having distant metastasis by imaging modalities, the incidence of peritoneal metastasis that was unexpectedly found during laparotomy was approximately 40%. Staging laparoscopy (SL) is a valuable method used for staging gastric cancer. This study aimed to clarify the effectiveness and limitations of SL for patients (pts) with type 4 or large type 3 gastric cancer. Methods: JCOG0501 is a randomized phase III trial of gastrectomy with or without neoadjuvant S-1 plus cisplatin for treating type 4 or large type 3 gastric cancer. Eligibility criteria included histologically proven gastric adenocarcinoma that was clinically type 4 or large type 3 gastric cancer and was diagnosed as R0/1-resectable using SL. Pts who underwent gastrectomy without neoadjuvant chemotherapy were included in this study. Results: In total, 316 pts (158 pts with and without neoadjuvant chemotherapy each) were enrolled between October 2005 and July 2013 from 44 institutions. Of the 158 pts without neoadjuvant therapy, 2 pts did not receive laparotomy. The remaining 156 pts were included in this analysis. Among them, except for 1 patient (P1), none were diagnosed with peritoneal metastases (P0) during SL. Among these 155 pts, 24 (15.5%) were diagnosed with peritoneal metastases at subsequent laparotomies (false-negative). Most of the overlooked peritoneal disseminated nodules were located in the intestinal mesentery (8 pts), transverse mesocolon (5 pts), or omental bursa (3 pts). The total number of peritoneal disseminated nodules at laparotomy was often ≤ 9 (1–3 nodules in 14 pts, 4–9 in 4 pts). Of the 156 included pts, 142 underwent R0/1-resection (91.0%) because some overlooked nodules were curatively resected. Conclusions: SL is a useful diagnostic tool to plan the management of type 4 and large type 3 gastric cancers, although the high false-negative rate cannot be ignored. In SL, detailed exploration of the mesentery, mesocolon, and omental bursa is recommended.

scholarly journals Clinical Significance of Staging Laparoscopy in the Diagnosis of Peritoneal Dissemination of Advanced Gastric Cancer

2016 ◽  
Vol 77 (11) ◽  
pp. 2631-2637
Author(s):  
Nobuo TAKATA ◽  
Takahiro KINOSHITA ◽  
Akio KAITO ◽  
Hidehito SHIBASAKI ◽  
Hideki SUNAGAWA ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Clinical Significance ◽  
Peritoneal Dissemination ◽  
Staging Laparoscopy

scholarly journals Neoadjuvant chemotherapy with S-1 and surgical resection for a mucinous gastric cancer with peritoneal dissemination

2005 ◽  
Vol 8 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Madoka Hamada ◽  
Akihito Tsuji ◽  
Jun Iwata ◽  
Yutaka Nishioka ◽  
Kazuhide Ozaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Resection ◽  
Peritoneal Dissemination

Surgery and metastases of stomach cancer in liver

2020 ◽  
pp. 21-24
Author(s):  
F. M. Dzhuraev ◽  
S. L. Gutorov ◽  
E. I. Borisova ◽  
G. G. Khakimova
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Lymphovascular Invasion ◽  
Peritoneal Dissemination ◽  
Surgical Removal ◽  
Relapse Free Survival ◽  
Cancer Markers ◽  
Free Survival ◽  
The Poor ◽  
Isolated Liver

Liver metastases of gastric cancer determine the poor prognosis. Until now The expediency of their surgical removal has been controversial. However, according to a number of studies, the removal of potentially operable isolated liver metastases allows a significant increase of overall and relapse-free survival in some cases. The review is dedicated to the analysis of prognostic factors that allow selecting patients for surgical removal of liver metastases of gastric cancer. The main criteria are: effective perioperative chemotherapy; stage under T4, N0, absence of lymphovascular invasion, absence of peritoneal dissemination, number less than 3, size up to 4 cm, localization of metastases in one lobe, low level of cancer markers CA 19-9 and CEA.

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