Hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant chemotherapy as prophylaxis of peritoneal carcinosis from advanced gastric cancer—effects on overall and disease free survival

e16019 Background: Postoperative adjuvant chemotherapy is commonly given after the curative resection of gastric cancer (GC) in both Eastern and Western countries. Several studies have investigated the feasibility and safety of S-1 plus docetaxel or S-1 plus cisplatin. However, the best choice of adjuvant treatment for patients with gastric cancer is still debated. Apatinib, an oral small molecular of VEGFR-2 TKI, has been confirmed to improve OS and PFS with acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy. In this study, we aimed to evaluate the efficacy and safety of apatinib combined with S-1/docetaxel for locally advanced gastric cancer (T3-4aN+M0). Methods: This is a prospective, randomized, controlled, multicenter clinical study. Patients with locally advanced gastric cancer, pathological stage T3-4aN+M0 who underwent D2 lymphadenectomy without prior anti-cancer therapy were included. All these patients were assigned to group A or B. Patients in group A received 6 cycles (21 days a cycle) of adjuvant therapy using S-1 (80-120mg/d, d1-14), and docetaxel (40mg/m2, d1). Group B received the same regimen with the addition of apatinib (250mg, qd.). The primary endpoint was disease-free survival (DFS). The final analysis cutoff date was 30 November, 2020. Results: A total of 45 patients were enrolled from January 2019 to November, 2010 and assigned to group A (21) or group B (24). The DFS was not reached in both of the groups. The 1-year disease-free survival rate was 60% in group A and 90% in the group B, while the difference was not significant. The main AEs in group A were anemia (55%), nausea (50%) and neutropenia (40%); The most common AEs in group B were anemia (45%) neutropenia (40%) and diarrhea (25%). There were no treatment-related deaths. The longest administered time of apatinib with no progression was 457 days. And the median time to receive apatinib was 329 days. Conclusions: Combination of apatinib with S-1/docexal chemotherapy shows clinical benefits in locally advanced gastric cancer (T3-4aN+M0), with tolerable toxicity. The study is still ongoing to reach our final endpoint, DFS. Clinical trial information: ChiCTR2000038900.

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Effect of Laparoscopic vs Open Distal Gastrectomy on 3-Year Disease-Free Survival in Patients With Locally Advanced Gastric Cancer

JAMA ◽

10.1001/jama.2019.5359 ◽

2019 ◽

Vol 321 (20) ◽

pp. 1983 ◽

Cited By ~ 90

Author(s):

Jiang Yu ◽

Changming Huang ◽

Yihong Sun ◽

Xiangqian Su ◽

Hui Cao ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Distal Gastrectomy ◽

Locally Advanced ◽

Disease Free Survival ◽

Open Distal Gastrectomy ◽

Free Survival ◽

Locally Advanced Gastric Cancer ◽

Disease Free

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Risk Factors and Clinicopathological Study of Prognostic Factors in the Peritoneal Mesothelioma

The American Surgeon ◽

10.1177/000313481007600418 ◽

2010 ◽

Vol 76 (4) ◽

pp. 400-405 ◽

Cited By ~ 1

Author(s):

Edward C.G. Tudor ◽

Terence C. Chua ◽

Winston Liauw ◽

David L. Morris

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Disease Free Survival ◽

Complete Cytoreduction ◽

Peritoneal Mesothelioma ◽

Free Survival ◽

Disease Free

This study evaluates the clinical and treatment related prognostic indicators for survival of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma. We did an observational study of the risk factors and clinicopathological factors of 20 patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma at the St George Hospital, Sydney. Survival analysis was performed using the Kaplan-Meier method and prognostic factors were correlated with survival using the Log Rank test. There were six females. The mean age was 55 years. The overall median survival was 30 (0.5-87) months with 1- and 3-year survival of 78 per cent and 46 per cent, respectively. The overall median disease-free survival was 8 months. Factors influencing a longer disease-free survival included age ≥ 55 ( P = 0.006), not smoking ( P = 0.04), female ( P = 0.03), and epithelioid tumors ( P = 0.002). Overall survival was influenced by not consuming alcohol ( P = 0.003), complete cytoreduction ( P = 0.02), and epithelioid tumors ( P = 0.01). Risk factors identified to be prognostic for survival include the female gender, not smoking, not consuming alcohol, and an epithelioid tumor type. Treatment factor associated with an improved survival was a complete cytoreduction.

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Survival according to mutations in BRAF, KRAS, or microsatellite instability (MSI-H) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastases from colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.3565 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 3565-3565 ◽

Cited By ~ 1

Author(s):

Stein G Larsen ◽

Svein Dueland ◽

M Goscinski ◽

Sonja Steigen ◽

Eva Hofsli ◽

...

Keyword(s):

Colorectal Cancer ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Disease Free Survival ◽

Peritoneal Metastases ◽

Wild Type ◽

Free Survival ◽

Crs And Hipec ◽

Disease Free

3565 Background: Patients with metastatic colorectal cancer (mCRC) and mutations in BRAF V600E (mutBRAF) or KRAS (mutKRAS) have a worse prognosis after liver or lung surgery/ablation, whereas the impact of microsatellite instability (MSI-H) has not been well studied. Few patients with mutBRAF receive liver or lung surgery (1-4%), whereas mutBRAF is present in 5-12% of mCRC trial patients and in up to 20% of the general mCRC population. The frequency and prognostic role of mutBRAF, mutKRAS and MSI has not been well studied after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases from colorectal cancer. Methods: The Norwegian Radium Hospital is the only center offering CRS and HIPEC in Norway. From 2004 to 2015 257 patients with histology proven peritoneal metastasis from colorectal cancer, appendiceal cancer excluded, was consecutively enrolled. Molecular analyses of KRAS, BRAF and MSS/MSI in mutBRAF were done. Fourteen patients were excluded due to missing tumour blocks (7), unsuccessful analysis (4) and other malignant disease (1). Results: 180 of 243 patients obtained complete cytoreductive surgery and received HIPEC for 90 minutes with Mitomycin C (45-70mg). Median survival for the 180 patients was 47 months and 5-year survival rate 40.1%. Median disease-free survival was 10 months. mutBRAF was found in 23.4% of cases, mutKRAS 35.1% and double-wild type 41.5%. mutBRAF with MSS was found in 16.4%, mutBRAF with MSI-H in 7.0%. 3-year disease free survival (DFS) and median overall survival (OS) was 38.9% and 59 months with mutBRAF with MSI-H, significantly higher compared to 24.2% and 30 months in patients with double wild type, 13.2 % and 41 months in mutKRAS and 17.9% and 22 months in mutBRAF with MSS. Conclusions: A surprisingly high frequency of mutBRAF was seen in mCRC patients after CRS and HIPEC for peritoneal metastatic disease. Patients with mutBRAF and MSI-H had a significantly better DFS and OS after CRS and HIPEC. DFS for patients with mutBRAF and MSS was numerically lower but not statistically different from patients with mutKRAS or double wild type.

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Epididymitis following Cytoreductive Surgery with Intraperitoneal Oxaliplatin Chemotherapy: Two Case Reports

Case Reports in Oncology ◽

10.1159/000443726 ◽

2016 ◽

Vol 9 (1) ◽

pp. 138-142 ◽

Cited By ~ 3

Author(s):

Luiza Damian Ribeiro Barbosa ◽

Marcos Belotto ◽

Renata D'Alpino Peixoto

Keyword(s):

Postoperative Complications ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Case Reports ◽

Disease Free Survival ◽

Aggressive Treatment ◽

Scrotal Pain ◽

Free Survival ◽

Disease Free

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy has emerged as an aggressive treatment option with intent to either cure or extend disease-free survival of selected patients with peritoneal carcinomatosis. However, postoperative complications are common. We describe the cases of 2 men who underwent CRS with hyperthermic intraperitoneal oxaliplatin and developed scrotal pain, which was consistent with noninfectious epididymitis.

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