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. 2017 Mar 15;9(3):121-128.
doi: 10.4251/wjgo.v9.i3.121.

Gastric peritoneal carcinomatosis - a retrospective review

Hwee Leong Tan  1 , Claramae Shulyn Chia  1 , Grace Hwei Ching Tan  1 , Su Pin Choo  1 , David Wai-Meng Tai  1 , Clarinda Wei Ling Chua  1 , Matthew Chau Hsien Ng  1 , Khee Chee Soo  1 , Melissa Ching Ching Teo  1
Affiliations

Gastric peritoneal carcinomatosis - a retrospective review

Hwee Leong Tan et al. World J Gastrointest Oncol. .

Abstract

Aim: To characterize patients with gastric peritoneal carcinomatosis (PC) and their typical clinical and treatment course with palliative systemic chemotherapy as the current standard of care.

Methods: We performed a retrospective electronic chart review of all patients with gastric adenocarcinoma with PC diagnosed at initial metastatic presentation between January 2010 and December 2014 in a single tertiary referral centre.

Results: We studied a total of 271 patients with a median age of 63.8 years and median follow-up duration of 5.1 mo. The majority (n = 217, 80.1%) had the peritoneum as the only site of metastasis at initial presentation. Palliative systemic chemotherapy was eventually planned for 175 (64.6%) of our patients at initial presentation, of which 171 were initiated on it. Choice of first-line regime was in accordance with the National Comprehensive Cancer Network Guidelines for Gastric Cancer Treatment. These patients underwent a median of one line of chemotherapy, completing a median of six cycles in total. Chemotherapy disruption due to unplanned hospitalizations occurred in 114 (66.7%), while cessation of chemotherapy occurred in 157 (91.8%), with 42 cessations primarily attributable to PC-related complications. Patients who had initiation of systemic chemotherapy had a significantly better median overall survival than those who did not (10.9 mo vs 1.6 mo, P < 0.001). Of patients who had initiation of systemic chemotherapy, those who experienced any disruptions to chemotherapy due to unplanned hospitalizations had a significantly worse median overall survival compared to those who did not (8.7 mo vs 14.6 mo, P < 0.001).

Conclusion: Gastric PC carries a grim prognosis with a clinical course fraught with disease-related complications which may attenuate any survival benefit which palliative systemic chemotherapy may have to offer. As such, investigational use of regional therapies is warranted and required validation in patients with isolated PC to maximize their survival outcomes in the long run.

Keywords: Gastric cancer; Peritoneal carcinomatosis.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflict-of-interests to declare for any of the authors.

Figures

Figure 1
Figure 1
Chemotherapy-related clinical course.
Figure 2
Figure 2
Overall survival of patients initiated on palliative systemic chemotherapy vs patients who received best supportive care upfront.
Figure 3
Figure 3
Overall survival of patients initiated on palliative systemic chemotherapy who had treatment disruptions vs without treatment disruptions.
See this image and copyright information in PMC

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