Intraperitoneal and Intravenous Paclitaxel Chemotherapy With Oral Capecitabine for Gastric Adenocarcinoma With Peritoneal Carcinomatosis

2019 ◽  
Author(s):  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Oral Capecitabine

scholarly journals Use of serum and peritoneal CEA and CA19-9 in prediction of peritoneal dissemination and survival of gastric adenocarcinoma patients: are they prognostic factors?

2018 ◽  
Vol 100 (4) ◽  
pp. 257-266 ◽  
Author(s):  
M Hasbahceci ◽  
FU Malya ◽  
E Kunduz ◽  
M Guzel ◽  
N Unver ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
High Serum ◽  
Peritoneal Washing ◽  
Peritoneal Washing Cytology ◽  
Serum Cea ◽  
The Impact ◽  
Disease Free

Introduction To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. Materials and methods Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Development of peritoneal carcinomatosis, including positive washing cytology, was regarded as main outcome. Gastric cancer outcomes as disease free and overall survival were analysed. Results There were 67 patients with a mean age of 60 ± 11 years. Positive peritoneal washing cytology was significantly associated with serum CA19-9 and high serum CA 19–9 group (P = 0.033 and P = 0.011, respectively). High peritoneal CEA was shown to be significantly associated with peritoneal carcinomatosis (P = 0.032). After a median follow up of 17 months, 48 patients (71.7%) were alive. Patients with peritoneal carcinomatosis showed significant poorer prognosis as shown by overall survival rate of 28.6%. Only serum CEA was significantly associated with lower disease free and overall survival (P = 0.002 and P = 0.001, respectively). Discussion and conclusion Serum CEA is shown to be significantly associated with poor prognosis for gastric cancer patients. Serum level of CA19-9 and high peritoneal CEA levels are significant predictors for positive peritoneal washing cytology and the development of peritoneal carcinomatosis, respectively. Therefore, the possible impact of serum and peritoneal tumor markers especially on the staging and prognosis of gastric cancer remains to be clarified by future studies.

scholarly journals Patient-derived cell lines and orthotopic mouse model of peritoneal carcinomatosis recapitulate molecular and phenotypic features of human gastric adenocarcinoma

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Shumei Song ◽  
Yan Xu ◽  
Longfei Huo ◽  
Shuangtao Zhao ◽  
Ruiping Wang ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Cell Lines ◽  
Molecular Mechanisms ◽  
Stem Cell Markers ◽  
Orthotopic Mouse Model ◽  
Cancer Stem Cell Markers ◽  
Phenotypic Features

Abstract Background Gastric adenocarcinoma with peritoneal carcinomatosis (PC) is therapy resistant and leads to poor survival. To study PC in depth, there is an urgent need to develop representative PC-derived cell lines and metastatic models to study molecular mechanisms of PC and for preclinical screening of new therapies. Methods PC cell lines were developed from patient-derived PC cells. The tumorigenicity and metastatic potential were investigated by subcutaneously (PDXs) and orthotopically. Karyotyping, whole-exome sequencing, RNA-sequencing, and functional studies were performed to molecularly define the cell lines and compare genomic and phenotypic features of PDX and donor PC cells. Results We established three PC cell lines (GA0518, GA0804, and GA0825) and characterized them in vitro. The doubling times were 22, 39, and 37 h for GA0518, GA0804, and GA0825, respectively. Expression of cancer stem cell markers (CD44, ALDH1, CD133 and YAP1) and activation of oncogenes varied among the cell lines. All three PC cell lines formed PDXs. Interestingly, all three PC cell lines formed tumors in the patient derived orthotopic (PDO) model and GA0518 cell line consistently produced PC in mice. Moreover, PDXs recapitulated transcriptomic and phenotypic features of the donor PC cells. Finally, these cell lines were suitable for preclinical testing of chemotherapy and target agents in vitro and in vivo. Conclusion We successfully established three patient-derived PC cell lines and an improved PDO model with high incidence of PC associated with malignant ascites. Thus, these cell lines and metastatic PDO model represent excellent resources for exploring metastatic mechanisms of PC in depth and for target drug screening and validation by interrogating GAC for translational studies.

scholarly journals IT IS NOT ALWAYS A CHOLANGIOCARCINOMA: UNUSUAL PERITONEAL CARCINOMATOSIS REVEALING GASTRIC ADENOCARCINOMA

2021 ◽  
Vol 9 (08) ◽  
pp. 408-412
Author(s):  
L. Kallouch ◽  
◽  
Y. Omor ◽  
R. Latib ◽  
◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Biliary Obstruction ◽  
Biliary Tree ◽  
Malignant Biliary Obstruction ◽  
Advanced Stage ◽  
Malignant Jaundice ◽  
Tumoral Lesion ◽  
Uncommon Complication

In more than 85% of cases, gastric cancer is discovered at an advanced stage. Malignant biliary obstruction is an uncommon complication of gastric cancer, this case report presents a case of a peritoneal carcinomatosis causing biliary obstruction with radiographic dilatation, mimicking cholangiocarcinoma, and secondary to gastric adenocarcinoma. The imaging investigation had decisive roles in the diagnosis and differential diagnosis of the malignant jaundice predominated by periductal infiltrating cholangiocarcinoma, this pattern of cholangiocarcinoma, is frequently found in perihilar cholangiocarcinoma, it typically shows marked dilatation on imaging of the biliary tree proximal to the tumoral lesion.

Usefulness of PET/CT in the diagnosis of distant metastases of potentially operable gastric adenocarcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15598-e15598
Author(s):  
R. Gallego ◽  
D. Fuster ◽  
A. Ginés ◽  
J. Ortín ◽  
J. R. Ayuso ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
False Negative ◽  
Distant Metastases ◽  
Whole Body ◽  
18F Fluorodeoxyglucose ◽  
Negative Case ◽  
Pet Ct

e15598 Background: 1) To evaluate the usefulness of Positron Emission Tomography with combined 18F-Fluorodeoxyglucose with Computed Tomography (PET/CT) in the diagnosis of distant metastases in patients with gastric adenocarcinoma (GAC) compared to spiral double contrast thoracoabdominal Computed Tomography (CT); 2) To establish the utility of PET/CT in the detection of peritoneal carcinomatosis compared to laparoscopy. Methods: Thirty prospective patients (22 men, 8 women; mean age 67±11) who underwent endoscopic ultrasound and were classified as T2–3N1 or T3Nx GAC were included in this study. Whole body images were obtained 1 hour after injection of 370 MBq of 18F-Fluorodeoxyglucose. CT was performed within 2 weeks of PET/CT. Laparoscopy was performed without remarkable incidences. All findings were confirmed by histopathology examination and/or by at least 6 months follow- up. Results: Distant metastases were found in 9/30 cases: carcinomatosis (3), retroperitoneal (3) or mediastinal (2) pathological lymph nodes and one case of bone metastases (1). PET/CT diagnosed unsuspected distant metastases by CT in 4/9 patients (retroperitoneal (1) or mediastinal (2) pathological lymph nodes and 1 case of bone metastasis in the spine). In 1/3 patients with histopathological confirmed diagnosis of peritoneal carcinomatosis by laparoscopic findings was negative by PET/CT, and considered as a false negative case. On the other hand, 3 patients with initially positive peritoneal carcinomatosis by invasive laparoscopy were finally diagnosed as benign lesions. These lesions did not show significant uptake in PET/CT and were considered as true negative cases. Conclusions: 1) PET/CT is useful in the diagnosis of distant metastases in patients with GAC 2) Further studies are needed to establish the role of PET/CT to detect peritoneal carcinomatosis. No significant financial relationships to disclose.

scholarly journals Head-to-head comparison of [68Ga]Ga-FAPI-04 and [18F]-FDG PET/CT in evaluating the extent of disease in gastric adenocarcinoma

2021 ◽  
Author(s):  
Jonathan Kuten ◽  
Charles Levine ◽  
Ofer Shamni ◽  
Sharon Pelles ◽  
Ido Wolf ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Fdg Pet ◽  
Detection Rate ◽  
Standardized Uptake Value ◽  
Lesion Detection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Extent Of Disease

Abstract Background [18F]-Fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) may sometimes be suboptimal for imaging gastric adenocarcinoma. The recently introduced [68Ga]Ga-FAPI-04 (FAPI) PET/CT targets tumor stroma and has shown considerable potential in evaluating the extent of disease in a variety of tumors. Methods We performed a head-to-head prospective comparison of FAPI and FDG PET/CT in the same group of 13 patients with gastric adenocarcinoma who presented for either initial staging (n = 10) or restaging (n = 3) of disease. Lesion detection and maximum standardized uptake value (SUVmax) were compared between the two types of radiotracers. Results All ten primary gastric tumors were FAPI-positive (100% detection rate), whereas only five were also FDG-positive (50%). SUVmax was not significantly different, but the tumor-to-background ratio was higher for FAPI (mean, median, and range of 4.5, 3.2, and 0.8–9.7 for FDG and 12.9, 11.9, and 2.2–23.9 for FAPI, P = 0.007). The level of detection of regional lymph node involvement was comparable. FAPI showed a superior detection rate for peritoneal carcinomatosis (100% vs. none). Two patients with widespread peritoneal carcinomatosis underwent a follow-up FAPI scan after chemotherapy: one showed partial remission and the other showed progressive disease. Conclusions The findings of this pilot study suggest that FAPI PET/CT outperforms FDG PET/CT in detecting both primary gastric adenocarcinoma and peritoneal carcinomatosis from gastric cancer. FAPI PET/CT also shows promise for monitoring response to treatment in patients with peritoneal carcinomatosis from gastric cancer; however, larger trials are needed to validate these preliminary findings.

scholarly journals Head-to-Head Comparison of [68Ga]Ga-FAPI-04 and [18F]-FDG PET/CT in Evaluating the Extent of Disease in Gastric Adenocarcinoma

2021 ◽  
Author(s):  
Jonathan Kuten ◽  
Charles Levine ◽  
Ofer Shamni ◽  
Sharon Pelles ◽  
Ido Wolf ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
Fdg Pet ◽  
Detection Rate ◽  
Standardized Uptake Value ◽  
Lesion Detection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Extent Of Disease

Abstract Background[18F]-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) may sometimes be suboptimal for imaging gastric adenocarcinoma. The recently introduced [68Ga]Ga-FAPI-04 (FAPI) PET/CT targets tumor stroma and has shown considerable potential in evaluating the extent of disease in a variety of tumors.MethodsWe performed a head-to-head prospective comparison of FAPI and FDG PET/CT in the same group of 13 patients with gastric adenocarcinoma who presented for either initial staging (n = 10) or restaging (n = 3) of disease. Lesion detection and maximum standardized uptake value (SUVmax) were compared between the two types of radiotracers.ResultsAll ten primary gastric tumors were FAPI-positive (100% detection rate), whereas only five were also FDG-positive (50%). SUVmax was not significantly different, but the tumor-to-background ratio was higher for FAPI (mean, median, and range of 4.5, 3.2, and 0.8-9.7 for FDG and 12.9, 11.9, and 2.2-23.9 for FAPI, P = 0.007). The level of detection of regional lymph node involvement was comparable. FAPI showed a superior detection rate for peritoneal carcinomatosis (100% vs. none). Two patients with widespread peritoneal carcinomatosis underwent a follow-up FAPI scan after chemotherapy: one showed partial remission and the other showed progressive disease.ConclusionsThe findings of this study suggest that FAPI PET/CT outperforms FDG PET/CT in detecting both primary gastric adenocarcinoma and peritoneal carcinomatosis from gastric cancer. FAPI PET/CT also shows promise for monitoring response to treatment in patients with peritoneal carcinomatosis from gastric cancer, however, larger trials are needed to validate these findings.

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