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Multicenter Study
. 2021 Nov 24;19(1):334.
doi: 10.1186/s12957-021-02442-9.

Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter Gastric Cancer Research group's analysis

Luigina Graziosi  1 , Elisabetta Marino  2 , Maria Bencivenga  3 , Alessia D'Ignazio  4 , Leonardo Solaini  5 , Silvia Ministrini  6 , Michela Caprioli  6 , Michele Sacco  3 , Daniele Marrelli  4 , Gianni Mura  7 , Maurizio Degiuli  8 , Paolo Morgagni  5 , Guido Alberto Massimo Tiberio  6 , Giovanni De Manzoni  3 , Franco Roviello  4 , Annibale Donini  1
Affiliations
Multicenter Study

Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter Gastric Cancer Research group's analysis

Luigina Graziosi et al. World J Surg Oncol. .

Abstract

Background: The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery.

Methods: It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences.

Results: Our results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could benefit from an aggressive surgical approach performing an extended lymphadenectomy and HIPEC treatment.

Conclusion: The main result of the study is that GC patients with limited peritoneal involvement can have a survival benefit from a surgery with "radical oncological intent", that means extended lymphadenectomy and R0 resection. The retrospective nature of this study is an important bias, and for this reason, we have started a prospective multicentric study including Italian stage IV patients that hopefully will give us more answers.

Keywords: Gastric cancer; Peritoneal carcinomatosis; Surgery.

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Conflict of interest statement

All the authors declare that they have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Flowchart of the patients enrolled in the study; *data will be presented in another paper
Fig. 2
Fig. 2
Disease-related survival of the entire population analyzed
Fig. 3
Fig. 3
a Disease-related survival of patients with macroscopic disease according to HIPEC treatment, p = 0.07; b disease related survival of patients treated with HIPEC according to the peritoneal involvement, p = 0.02
Fig. 4
Fig. 4
a Disease-related survival according to lymphadenectomy extension, p = 0.04; b disease-related survival according to completeness of surgical resection, p = 0.01
Fig. 5
Fig. 5
Disease-related survival according to pathological T stage (a), pathological N stage (b), and peritoneal involvement (c); p = 0.002, 0.003, and 0.023, respectively
See this image and copyright information in PMC

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References

    1. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F. Global cancer observatory: cancer today. Lyon: International Agency for Research on Cancer; 2018.
    1. Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, 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;3:215–221. doi: 10.1016/S1470-2045(08)70035-4. - DOI - PubMed
    1. Yoshida K, Ninomiya M, Takakura N, Hirabayashi N, Takiyama W, Sato Y, et al. Phase II study of docetaxel and S-1 combination therapy for advanced or recurrent gastric cancer. Clin Cancer Res. 2006;12:3402–3407. doi: 10.1158/1078-0432.CCR-05-2425. - DOI - PubMed
    1. Koizumi W, Kim YH, Fujii M, Kim HK, Imamura H, Lee KH, et al. Addition of docetaxel to S-1 without platinum prolongs survival of patients with advanced gastric cancer: a randomized study (START) J Cancer Res Clin Oncol. 2014;140:319–328. doi: 10.1007/s00432-013-1563-5. - DOI - PMC - PubMed
    1. Tanabe K, Suzuki T, Tokumoto N, Yamamoto H, Yoshida K, Ohdan H. Combination therapy with docetaxel and S-1 as a first-line treatment in patients with advanced or recurrent gastric cancer: a retrospective analysis. World J Surg Oncol. 2010;8:40. doi: 10.1186/1477-7819-8-40. - DOI - PMC - PubMed

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