Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy versus palliative systemic chemotherapy in stomach cancer patients with peritoneal dissemination, the study protocol of a multicentre randomised controlled trial (PERISCOPE II)

Koemans, Willem J.; Kaaij, Rosa T. van der; Boot, H.; Buffart, Tineke E.; Veenhof, A. A. F. A.; Hartemink, Koen J.; Grootscholten, Cecile; Snæbjörnsson, Pétur; Retèl, Valesca P.; Tinteren, Harm van; Vanhoutvin, Steven; Noort, Vincent van der; Houwink, Aletta P. I.; Hahn, ChangHoon; Huitema, Alwin D. R.; Lahaye, Max J.; Los, Maartje; Barselaar, P. van den; Imhof, O.; Aalbers, Arend G. J.; Dam, Gooitzen M. van; Etten, Boudewijn van; Wijnhoven, Bas P. L.; Luyer, Misha; Boerma, Djamila; Sandick, Johanna W. van

doi:10.1186/s12885-019-5640-2

Cited by 83 publications

(73 citation statements)

References 31 publications

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“…Further clinical studies are warranted to investigate if a pre-treatment diagnostic laparoscopy could also be of value for these patients[ 26 , 27 ]. Furthermore, knowledge of the preference location of metastases may help to develop individualized treatment strategies in case of metastatic disease such as Selective liver Internal Radiation therapy (SIRT) for liver metastases or adjuvant pressurized intraperitoneal aerosol chemotherapy or hyperthermic intraperitoneal chemotherapy for peritoneal metastases[ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Verstegen

Harker

Water

et al. 2020

WJG

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BACKGROUND Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited. Early recognition of metastases is important to avoid futile locoregional treatments. Furthermore, knowledge on metastatic patterns is necessary for further development of personalized treatment modalities. AIM To gain insight into the metastatic pattern of gastroesophageal cancer. METHODS A nationwide retrospective autopsy study of 3876 patients with adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the esophagus or stomach between 1990 and 2017 was performed. Only patient with metastases were included for analysis. The metastatic pattern was analyzed according to the primary tumor location and histological subtype. RESULTS Metastatic disease was found in 268 esophageal and 331 gastric cancer patients. In esophageal cancer, the most common metastatic locations were liver (56%), distant lymph nodes (53%) and lung (50%). Esophageal AC showed more frequently metastases to the peritoneum and bone compared with esophageal SCC. In gastric cancer, the most common metastatic locations were distant lymph nodes (56%), liver (53%) and peritoneum (51%). Intestinal-type AC of the stomach showed metastases to the liver more frequently, whereas metastases to the bone, female reproductive organs and colorectum were observed more frequently in diffuse-type gastric AC. CONCLUSION This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.

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Section: Discussionmentioning

confidence: 99%

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Verstegen

Harker

Water

et al. 2020

WJG

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“…Median survival of 10–43 months after HIPEC for gastric carcinomatosis has been reached in selected groups. To study patient survival, a randomized phase III trial has been initiated (PERISCOPE II; NCT03348150), using the combination of intraperitoneal oxaliplatin and docetaxel as presented (dose level 2). In the PERISCOPE II study, patients with gastric cancer and limited peritoneal carcinomatosis (PCI below 7) and/or tumour‐positive cytology, and no disease progression during systemic chemotherapy, are allocated randomly to the experimental treatment (operation with HIPEC) or the current standard treatment in the Netherlands (palliative systemic chemotherapy).…”

Section: Discussionmentioning

confidence: 99%

Treatment of PERItoneal disease in Stomach Cancer with cytOreductive surgery and hyperthermic intraPEritoneal chemotherapy: PERISCOPE I initial results

Kaaij

Wassenaar

Koemans

et al. 2020

British Journal of Surgery

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Background The role of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer is unknown. This non‐randomized dose‐finding phase I–II study was designed to assess the safety and feasibility of HIPEC, following systemic chemotherapy, in patients with gastric cancer and limited peritoneal dissemination. The maximum tolerated dose of normothermic intraperitoneal docetaxel in combination with a fixed dose of intraperitoneal oxaliplatin was also explored. Methods Patients with resectable cT3–cT4a gastric adenocarcinoma with limited peritoneal metastases and/or tumour‐positive peritoneal cytology were included. An open HIPEC technique was used with 460 mg/m2 hyperthermic oxaliplatin for 30 min followed by normothermic docetaxel for 90 min in escalating doses (0, 50, 75 mg/m2). Results Between 2014 and 2017, 37 patients were included. Of 25 patients who completed the full study protocol, four were treated at dose level 1 (0 mg/m2 docetaxel), six at dose level 2 (50 mg/m2) and four at dose level 3 (75 mg/m2). At dose level 3, two dose‐limiting toxicities occurred, both associated with postoperative ileus. Thereafter, another 11 patients were treated at dose level 2, with no more dose‐limiting toxicities. Based on this, the maximum tolerated dose was 50 mg/m2 intraperitoneal docetaxel. Serious adverse events were scored in 17 of 25 patients. The reoperation rate was 16 per cent (4 of 25) and the treatment‐related mortality rate was 8 per cent (2 patients, both in dose level 3). Conclusion Gastrectomy combined with cytoreductive surgery and HIPEC was feasible using 460 mg/m2 oxaliplatin and 50 mg/m2 normothermic docetaxel.

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“…Extended gastrectomy combined with peritonectomy and HIPEC may be beneficial to strictly selected patients with oligometastatic peritoneal GC [ 36 , 37 ]. The ongoing phase III RCT’s in the West will determine the potential survival benefit of HIPEC in advanced GC [ 38 , 39 ]. The present study shows that HIPEC might result in an increased risk of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Mixed Type Histology as a Predictive Factor for Esophagojejunostomy Leak in Advanced Gastric Cancer

Rawicz‐Pruszyński

Sędłak

Mlak

et al. 2020

Cancers

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Since esophagojejunostomy leak (EJL) after gastrectomy is a potentially fatal complication and may impact the survival of patients with advanced gastric cancer (GC), it is important to establish risk factors for the EJL and to prevent this surgical complication. The aim of this study was analysis of predictors for the postoperative clinically apparent EJL. All patients operated for advanced GC between October 2016 and December 2019 were analyzed from a prospectively maintained database. The evaluation of the EJL and postoperative complications according to the demographic and clinical (categorized) variables was performed with odds ratio test (multivariate analysis was performed with the use of logistic regression method). Among the 114 patients included in the study, 71.1% received neoadjuvant chemotherapy and 19.3% underwent gastrectomy followed by the hyperthermic intraperitoneal chemotherapy (HIPEC). Postoperative EJL was found in 4.6% patients. The risk of EJL was significantly higher for mixed-type GC (OR = 12.45, 95% CI: 1.03–150.10; p = 0.0472). The risk of other postoperative complications was significantly higher in patients undergoing HIPEC (OR = 3.88, 95% CI: 1.40–10.80, p = 0.0094). The number of lymph nodes removed (>38) was characterized by 80% sensitivity and 79.6% specificity in predicting EJL (AUC = 0.80, 95% CI: 0.72–0.87; p < 0.0001). Mixed histological type of GC is a tumor-related risk factor for the EJL. HIPEC was confirmed to be a risk factor for postoperative complications after gastrectomy.

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy versus palliative systemic chemotherapy in stomach cancer patients with peritoneal dissemination, the study protocol of a multicentre randomised controlled trial (PERISCOPE II)

Cited by 83 publications

References 31 publications

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Treatment of PERItoneal disease in Stomach Cancer with cytOreductive surgery and hyperthermic intraPEritoneal chemotherapy: PERISCOPE I initial results

Mixed Type Histology as a Predictive Factor for Esophagojejunostomy Leak in Advanced Gastric Cancer

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