A new scoring system for peritoneal metastasis in gastric cancer

Fujimura, Takashi; Ishii, Kaname; Oyama, Katsunobu; Miyashita, Tomoharu; Kinami, Shinichi; Ninomiya, Itasu; Kitagawa, Hirohisa; Fushida, Sachio; Nishimura, Genichi; Kayahara, Masato; Shimizu, Koïchi; Ohta, Tetsuo; Miwa, Koichi

doi:10.1007/s10120-003-0243-6

Cited by 14 publications

(15 citation statements)

References 8 publications

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“…Peritoneal metastasis (PM) occurs in more than 50 % of patients with unresectable and recurrent gastric cancer through their clinical course, and it causes various complications, such as ascites, intestinal stenosis, hydronephrosis, and obstructive jaundice; the prognosis of patients with severe PM is dismal and generally worse than that of those without PM [8]. The Japan Clinical Oncology Group (JCOG) conducted a randomized phase III study (JCOG0106) of 5-fluorouracil (5-FU) continuous infusion (5-FUci) versus sequential methotrexate (MTX) and 5-FU therapy in patients having AGC with PM and concluded that 5-FUci, which is one of the most feasible regimens, is the standard first-line chemotherapy for such patients [9].…”

Section: Introductionmentioning

confidence: 99%

Randomized phase II study of second-line chemotherapy with the best available 5-fluorouracil regimen versus weekly administration of paclitaxel in far advanced gastric cancer with severe peritoneal metastases refractory to 5-fluorouracil-containing regimens (JCOG0407)

Nishina

Boku²,

Gotoh

et al. 2015

Gastric Cancer

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Background This randomized phase II study compared weekly administration of paclitaxel (wPTX) with the best available 5-fluorouracil (5-FU) regimen as second-line treatment for advanced gastric cancer patients with severe peritoneal metastasis refractory to fluoropyrimidine. Methods In the best available 5-FU arm, continuous infusion of 5-FU (800 mg/m 2 /day, days 1-5, every 4 weeks) was given to patients with prior chemotherapy including bolus 5-FU, and methotrexate and 5-FU sequential bolus injection (methotrexate at 100 mg/m 2 followed by bolus 5-FU at 600 mg/m 2 with leucovorin, weekly) was given to those who had previously received continuous infusion of 5-FU or oral administration of fluoropyrimidine. In the wPTX arm, paclitaxel (80 mg/m 2 ) was administered on days 1, 8, and 15, every 4 weeks. This study adopted a screening design (one-sided a = 30 %) with the primary end point of overall survival. Results One hundred patients were randomized to the 5-FU arm (n = 49) or the wPTX arm (n = 51). Although the median survival time was 7.7 months in both arms, the 2-year survival rates were 2.9 % in the 5-FU arm and 9.1 % in the wPTX arm [hazard ratio 0.89 (95 % confidence interval 0.57-1.38), one-sided p = 0.298}. The median progression-free survival was longer with wPTX than with 5-FU [3.7 months vs 2.4 months; hazard ratio 0.58 (95 % confidence interval 0.38-0.88), one-sided The incidences of grade 4 neutropenia, grade 3/4 febrile neutropenia, diarrhea, and treatment-related death were 6 %, 4 %, 10 %, and 2 %, respectively, in the 5-FU arm and 2 %, 0 %, 0 %, and 0 %, respectively, in the wPTX arm. ConclusionsAs second-line chemotherapy, wPTX appears feasible and promising. This regimen can be included in a test arm in future phase III trials for treatment of advanced gastric cancer with severe peritoneal metastasis.

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Section: Introductionmentioning

confidence: 99%

Randomized phase II study of second-line chemotherapy with the best available 5-fluorouracil regimen versus weekly administration of paclitaxel in far advanced gastric cancer with severe peritoneal metastases refractory to 5-fluorouracil-containing regimens (JCOG0407)

Nishina

Boku²,

Gotoh

et al. 2015

Gastric Cancer

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“…( 1 ) The most frequent cause of death of gastric cancer patients is peritoneal metastasis, which is difficult to diagnose preoperatively and to cure completely by surgery or chemotherapy. ( 2 ) Therefore, the development of new therapeutic/preventive strategies for peritoneal metastasis of gastric cancer is desired.…”

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confidence: 99%

Targeting Id1 and Id3 inhibits peritoneal metastasis of gastric cancer

Tsuchiya¹,

Okaji²,

Tsuno

et al. 2005

Cancer Science

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Inhibitor of DNA binding (Id) proteins are essential for cell differentiation, proliferation, migration, invasion and angiogenesis. Recently, they have been shown to correlate with less differentiated phenotypes, high malignant potential and poor clinical outcome in various kinds of tumors. In an attempt to develop new strategies for the treatment of peritoneal metastasis of gastric cancer, we prepared an Id1, 3 double-knockdown gastric cancer cell line, MKN45, by RNA interference and investigated its effects on the development of metastatic nodules in the peritoneal cavity. Both cell proliferation and migration capabilities were decreased in Id1, 3 double-knockdown cells, as was their ability to bind to laminin, which could be explained by the decreased expression of integrin alpha6. These are important steps in the metastatic process. In a mouse model, the number of peritoneal metastatic nodules formed by Id1, 3 double-knockdown cells was reduced compared to mock-transfected control cells, as was the size of individual tumors. In this study, we clearly demonstrated that Id1, 3 double-knockdown significantly impaired the ability of gastric cancer cells to form peritoneal metastasis. Id should be considered an ideal target for the treatment and prevention of gastric cancer, and RNA interference is an attractive and promising strategy to achieve it.

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“…• local unresectability (because of infiltrating tumor growth into relevant neighboring anatomical structures), • hepatic or other distant metastases, • tumor growth within more distant lymph nodes or • peritoneal tumor spread [6,10].…”

Section: Methodsmentioning

confidence: 99%

“…A significantly longer survival time has been seen (10.5 vs. 6.7 months) in the case of only one criterion of unresectability, whereas median survival time did not significantly differ in the case of two or three sites of metastatic tumor growth [10]. The ''Japanese Research Society for Gastric Cancer'' tried to differentiate the various extent of peritoneal tumor growth for the first time in 1995 by subdividing the peritoneal tumor spread into various stages of peritoneal carcinomatosis (P0-P3) [6]. However, despite multiple modifications, this classification has only achieved limited importance in clinical research because of its ambiguity and difficult use in daily clinical practice.…”

Section: Perioperative Morbidity and Mortalitymentioning

confidence: 97%

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Gastric carcinoma: when is palliative gastrectomy justified?

2010

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Gastric carcinoma is frequently diagnosed with an advanced stage of non-curable tumor growth characterized by infiltration of the gastric serosa, peritoneal tumor spread and/or metastases within lymph nodes and liver. Currently, there is a controversy on the value of palliative resection with regard to the safety and benefit to the patient outcome. Based on the available literature, this overview summarizes the various aspects and interprets the limited data on the palliative resection of gastric carcinoma. It turns out that the available study results may indicate potential for an improved quality of life and a prolongation of survival if an acceptable morbidity and mortality are present.

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A new scoring system for peritoneal metastasis in gastric cancer

Abstract: tumor, and resection of peritoneal tumor were independent factors to predict prognosis. Conclusion. These results showed that the volume scoring system was strongly related to the prognosis, and the patients assessed as Gr I had a great probability of cure by surgery.

Cited by 14 publications

References 8 publications

Randomized phase II study of second-line chemotherapy with the best available 5-fluorouracil regimen versus weekly administration of paclitaxel in far advanced gastric cancer with severe peritoneal metastases refractory to 5-fluorouracil-containing regimens (JCOG0407)

Randomized phase II study of second-line chemotherapy with the best available 5-fluorouracil regimen versus weekly administration of paclitaxel in far advanced gastric cancer with severe peritoneal metastases refractory to 5-fluorouracil-containing regimens (JCOG0407)

Targeting Id1 and Id3 inhibits peritoneal metastasis of gastric cancer

Gastric carcinoma: when is palliative gastrectomy justified?

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