Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis

Background. Patients with advanced gastric cancer (AGC) with peritoneal carcinomatosis (PC) usually have poor outcomes and high mortality risk, even with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). This study analyzed the prognostic factors of AGC with PC and e...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ting-Ying Lee, Guo-Shiou Liao, Hsiu-Lung Fan, Chung-Bao Hsieh, Teng-Wei Chen, De-Chuan Chan
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c9bef4de70b3428e904e7ab25a4cd7c3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c9bef4de70b3428e904e7ab25a4cd7c3
record_format	dspace
spelling	oai:doaj.org-article:c9bef4de70b3428e904e7ab25a4cd7c32021-11-22T01:11:13ZConversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis1687-846910.1155/2021/5459432https://doaj.org/article/c9bef4de70b3428e904e7ab25a4cd7c32021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/5459432https://doaj.org/toc/1687-8469Background. Patients with advanced gastric cancer (AGC) with peritoneal carcinomatosis (PC) usually have poor outcomes and high mortality risk, even with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). This study analyzed the prognostic factors of AGC with PC and evaluated laparoscopic HIPEC (LHIPEC) plus neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) as a conversion surgery for AGC patients with PC with a poor initial prognosis. Patient and Methods. We retrospectively evaluated 127 patients with AGC and PC from January 1, 2012, to March 1, 2020. After the exclusion of 32 ineligible patients, the conversion group comprised 34 patients who underwent LHIPEC + NIPS as a conversion surgery followed by CRS plus HIPEC. The CRS + HIPEC group included 15 patients who underwent CRS with HIPEC alone. Additionally, the C/T group comprised 23 patients who received systemic chemotherapy, and the palliative group comprised 23 patients who received only conservative therapy or palliative gastrectomy. Results. The conversion group demonstrated a significantly better mean overall survival compared to the CRS + HIPEC, C/T, and palliative groups (p<0.001). Patients in the conversion group who underwent LHIPEC + NIPS had significantly decreased peritoneal cancer index (PCI) scores (p<0.001) and ascites (p=0.003). Malignant ascites amount also significantly decreased after treatment in the LHIPEC + NIPS group (p<0.001). Conclusions. LHIPEC + NIPS can significantly improve the overall survival, the PCI score, and malignant ascites amount in peritoneal cytology-positive gastric cancer with PC, and an initially high PCI score. Therefore, it may be a feasible conversion strategy for AGC patients with PC.Ting-Ying LeeGuo-Shiou LiaoHsiu-Lung FanChung-Bao HsiehTeng-Wei ChenDe-Chuan ChanHindawi LimitedarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJournal of Oncology, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Ting-Ying Lee Guo-Shiou Liao Hsiu-Lung Fan Chung-Bao Hsieh Teng-Wei Chen De-Chuan Chan Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
description	Background. Patients with advanced gastric cancer (AGC) with peritoneal carcinomatosis (PC) usually have poor outcomes and high mortality risk, even with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). This study analyzed the prognostic factors of AGC with PC and evaluated laparoscopic HIPEC (LHIPEC) plus neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) as a conversion surgery for AGC patients with PC with a poor initial prognosis. Patient and Methods. We retrospectively evaluated 127 patients with AGC and PC from January 1, 2012, to March 1, 2020. After the exclusion of 32 ineligible patients, the conversion group comprised 34 patients who underwent LHIPEC + NIPS as a conversion surgery followed by CRS plus HIPEC. The CRS + HIPEC group included 15 patients who underwent CRS with HIPEC alone. Additionally, the C/T group comprised 23 patients who received systemic chemotherapy, and the palliative group comprised 23 patients who received only conservative therapy or palliative gastrectomy. Results. The conversion group demonstrated a significantly better mean overall survival compared to the CRS + HIPEC, C/T, and palliative groups (p<0.001). Patients in the conversion group who underwent LHIPEC + NIPS had significantly decreased peritoneal cancer index (PCI) scores (p<0.001) and ascites (p=0.003). Malignant ascites amount also significantly decreased after treatment in the LHIPEC + NIPS group (p<0.001). Conclusions. LHIPEC + NIPS can significantly improve the overall survival, the PCI score, and malignant ascites amount in peritoneal cytology-positive gastric cancer with PC, and an initially high PCI score. Therefore, it may be a feasible conversion strategy for AGC patients with PC.
format	article
author	Ting-Ying Lee Guo-Shiou Liao Hsiu-Lung Fan Chung-Bao Hsieh Teng-Wei Chen De-Chuan Chan
author_facet	Ting-Ying Lee Guo-Shiou Liao Hsiu-Lung Fan Chung-Bao Hsieh Teng-Wei Chen De-Chuan Chan
author_sort	Ting-Ying Lee
title	Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
title_short	Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
title_full	Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
title_fullStr	Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
title_full_unstemmed	Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis
title_sort	conversion surgery for patients with advanced gastric cancer with peritoneal carcinomatosis
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/c9bef4de70b3428e904e7ab25a4cd7c3
work_keys_str_mv	AT tingyinglee conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis AT guoshiouliao conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis AT hsiulungfan conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis AT chungbaohsieh conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis AT tengweichen conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis AT dechuanchan conversionsurgeryforpatientswithadvancedgastriccancerwithperitonealcarcinomatosis
_version_	1718418307152871424

Conversion Surgery for Patients with Advanced Gastric Cancer with Peritoneal Carcinomatosis

Ejemplares similares