Current Evidence for the Use of HIPEC and Cytoreductive Surgery in Gastric Cancer Metastatic to the Peritoneum

Jain, Anish J.; Badgwell, Brian D.

doi:10.3390/jcm12206527

Cited by 5 publications

(2 citation statements)

References 65 publications

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“…This technique can classify patients with GC at diagnosis, indicating a poorer prognosis for those with positive cytology in PLF. Therefore, it is advisable to implement preemptive interventional measures such as hyperthermic intraperitoneal chemotherapy (HIPEC) for this high-risk population ( Lei et al, 2020 ; Jain & Badgwell, 2023 ; Buckarma et al, 2024 ; Xu & Wang, 2023 ). Our follow-up research plan is to treat FCCs-positive patients with HIPEC (using nab-paclitaxel) and compare their outcomes to those of FCCs-positive patients not receiving HIPEC and FCCs-negative patients, to explore the preventive effect of HIPEC on patients with OPM.…”

Section: Discussionmentioning

confidence: 99%

Positive peritoneal lavage fluid cytology based on isolation by size of epithelial tumor cells indicates a high risk of peritoneal metastasis

Xuan,

Gao,

Wang

et al. 2024

PeerJ

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Background Peritoneal metastasis (PM) is the most prevalent type of metastasis in patients with gastric cancer (GC) and has an extremely poor prognosis. The detection of free cancer cells (FCCs) in the peritoneal cavity has been demonstrated to be one of the worst prognostic factors for GC. However, there is a lack of sensitive detection methods for FCCs in the peritoneal cavity. This study aimed to use a new peritoneal lavage fluid cytology examination to detect FCCs in patients with GC, and to explore its clinical significance on diagnosing of occult peritoneal metastasis (OPM) and prognosis. Methods Peritoneal lavage fluid from 50 patients with GC was obtained and processed via the isolation by size of epithelial tumor cells (ISET) method. Immunofluorescence and fluorescence in situ hybridization (FISH) were used to identify FCCs expressing chromosome 8 (CEP8), chromosome 17 (CEP17), and epithelial cell adhesion molecule (EpCAM). Results Using a combination of the ISET platform and immunofluorescence-FISH, the detection of FCCs was higher than that by light microscopy (24.0% vs. 2.0%). Samples were categorized into positive and negative groups, based on the expressions of CEP8, CEP17, and EpCAM. Statistically significant relationships were demonstrated between age (P = 0.029), sex (P = 0.002), lymphatic invasion (P = 0.001), pTNM stage (P = 0.001), and positivity for FCCs. After adjusting for covariates, patients with positive FCCs had lower progression-free survival than patients with negative FCCs. Conclusion The ISET platform highly enriched nucleated cells from peritoneal lavage fluid, and indicators comprising EpCAM, CEP8, and CEP17 confirmed the diagnosis of FCCs. As a potential detection method, it offers an opportunity for early intervention of OPM and an extension of patient survival.

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Section: Discussionmentioning

confidence: 99%

Positive peritoneal lavage fluid cytology based on isolation by size of epithelial tumor cells indicates a high risk of peritoneal metastasis

Xuan,

Gao,

Wang

et al. 2024

PeerJ

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“…2,3 However, the criteria used to identify such cases have not been prospectively validated and are largely based on the attitude and expertise of the single multidisciplinary teams. 4…”

Section: To the Editormentioning

confidence: 99%

Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Carcinomatosis: The Need for Clear Answers Through Proper Questions

Salani,

Vivaldi,

Rreka

et al. 2024

JCO

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Rau et al 1 recently reported the results of the GASTRIPEC-I trial, comparing cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with metastatic gastric cancer and synchronous, peritoneal-only metastases. We congratulate the authors, as it is particularly challenging completing informative trials in this setting. Indeed, the oncosurgical approach is now mentioned in guidelines, but it is still suggested as a caseby-case decision in highly selected patients. 2,3 However, the criteria used to identify such cases have not been prospectively validated and are largely based on the attitude and expertise of the single multidisciplinary teams.

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Massive neoplastic ascites

Guadagni

2023

Il Giornale Di Chirurgia - Journal of the Italian Association of Hospital Surgeons

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Peritoneal metastases frequently occur in primary or recurrent abdominal malignancy and are often associated with massive ascites, which determines severe abdominal bloating, respiratory distress, and poor quality of life in patients with few months of life. After the failure of traditional medical therapies, simple drainage is effective in providing temporary symptom relief but does not provide a durable solution. Several treatment options are available, but no standard treatment strategy has been established, and none of the treatments consistently showed the ability to extend life expectancy. This review focuses on outcomes and adverse events of simple drainage, catheter placement, intraperitoneal therapy, peritoneovenous shunting, hyperthermic intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy, pressurized intraperitoneal aerosol chemotherapy, and cell-free and concentrated ascites reinfusion therapy. The choice between the available options for durable symptom management requires both care and caution in weighing risks and benefits according to the patient’s life expectancy.

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Current Evidence for the Use of HIPEC and Cytoreductive Surgery in Gastric Cancer Metastatic to the Peritoneum

Cited by 5 publications

References 65 publications

Positive peritoneal lavage fluid cytology based on isolation by size of epithelial tumor cells indicates a high risk of peritoneal metastasis

Positive peritoneal lavage fluid cytology based on isolation by size of epithelial tumor cells indicates a high risk of peritoneal metastasis

Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Carcinomatosis: The Need for Clear Answers Through Proper Questions

Massive neoplastic ascites

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