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Review
. 2018 Feb 16;2(2):116-123.
doi: 10.1002/ags3.12060. eCollection 2018 Mar.

Treatment of patients with peritoneal metastases from gastric cancer

Joji Kitayama  1 , Hironori Ishigami  2 , Hironori Yamaguchi  1 , Yasunaru Sakuma  1 , Hisanaga Horie  1 , Yoshinori Hosoya  1 , Alan Kawarai Lefor  1 , Naohiro Sata  1
Affiliations
Review

Treatment of patients with peritoneal metastases from gastric cancer

Joji Kitayama et al. Ann Gastroenterol Surg. .

Abstract

Despite recent advances in chemotherapy, outcomes of patients with peritoneal metastases (PM) from gastric cancer are still very poor and standard treatment has not been established. Although oral S-1 appears to be effective for patients with PM, the effects of systemic chemotherapy are limited. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) yield fewer benefits in patients with PM from gastric cancer than in patients with PM from other malignancies. In comparison, repeated intraperitoneal chemotherapy (RIPEC) with taxanes using an implantable peritoneal access port has a pharmacokinetic advantage for the control of peritoneal lesions and in combination with systemic chemotherapy can result in surprisingly long-term survival in patients with PM from gastric cancer. Herein, we review the results of recent clinical studies specifically targeting PM from gastric cancer and discuss future prospects for an intraperitoneal approach to the ideal treatment of patients with gastric cancer with peritoneal involvement.

Keywords: HIPEC; gastric cancer; intraperitoneal chemotherapy; peritoneal metastasis.

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Figures

Figure 1
Figure 1
Left: Repeated intraperitoneal chemotherapy using an implantable port system. The catheter is placed in the pouch of Douglas (arrows) and taxanes dissolved in 500~1000 mL saline infused over 60 min. Right: Representative laparoscopic and X‐ray views of intraperitoneal port and catheter
Figure 2
Figure 2
Representative laparoscopic views of peritoneal metastases before and after repeated intraperitoneal chemotherapy
See this image and copyright information in PMC

References

    1. Stomach cancer estimated incidence, mortality and prevalence, worldwide. 2012 GLOBOCAN. 2012.
    1. Nashimoto A, Akazawa K, Isobe Y, et al. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer. 2013;16:1–27. - PMC - PubMed
    1. Coccolini F, Cotte E, Glehen O, et al. Intraperitoneal chemotherapy in advanced gastric cancer. Meta‐analysis of randomized trials. Eur J Surg Oncol. 2014;40:12–26. - PubMed
    1. Koizumi W, Narahara H, Hara T, et al. S‐1 plus cisplatin versus S‐1 alone for first‐line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21. - PubMed
    1. Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5‐fluorouracil/cisplatin as first‐line therapy in patients with advanced gastric cancer: a randomised phase III noninferiority trial. Ann Oncol. 2009;20:666–73. - PubMed

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