Effective therapy for peritoneal dissemination in gastric cancer

Yonemura, Yutaka; Bandou, Etsurou; Kinoshita, Kazuo; Kawamura, Taiichi; Takahashi, Shigeru; Endou, Yoshio; Sasaki, Takuma

doi:10.1016/s1055-3207(03)00035-8

Cited by 75 publications

(55 citation statements)

References 15 publications

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“…New bidirectional chemotherapy (neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS)) was developed to induce a reduction of the volume of PC volume [8]. NIPS could attack PC from both sides, not only from the peritoneal cavity but also from the subperitoneal blood vessels.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Yonemura¹,

Endou

Shinbo

et al. 2009

Journal of Surgical Oncology

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115

112

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There is no standard treatment for peritoneal carcinomatosis (PC) from gastric cancer. New bidirectional chemotherapy (neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS)) was developed. The aim of the present study was to assess the safety and efficacy of NIPS and to show the selection for cytoreductive surgery on PC from gastric cancer. Seventy-nine patients with PC from gastric cancer were treated with NIPS. A peritoneal port system was introduced into the abdominal cavity. The peritoneal wash cytological examination through a port was done before and after NIPS. The patients were treated with oral TS-1 twice a daily for 21 days, followed by a 1-week rest. On day 1, 8, and 15 from the start of oral TS-1 administration, 30 mg/m 2 of Docetaxel and 30 mg/m 2 of cisplatinum with 500 ml of saline were introduced into the peritoneal cavity through the port. A median course of oral TS-1 was 2.1 course and a median time of IP chemoterapy was 5.8. Peritoneal free cancer cells (PFCCs) had been detected in 65 (82.2%) patients before NIPS, and the positive cytology changed to be negative in 41 (63.0%) patients after NIPS. After NIPS, 41 patients underwent laparotomy, and complete cytoreduction was done in 32 (78%) patients. Complete cytoreduction was done in 27 (51.9%) of 52 patients with negative cytology but in only 4 (14.8%) of 27 patients with positive cytology (P < 0.001). Patients with negative cytology after NIPS survived significantly longer than those with positive cytology. The adverse effects after NIPS were mild and there was no treatment-related deaths. The grade 3/4 hematological adverse effects were found in 2 (2.6%) patients. Grade 3 renal toxicity and port site infection was found in three patients, respectively. NIPS using a port system is a safe and effective treatment for PC. Peritoneal wash cytology through a port system is a good indicator to select the patients to perform cytoreductive surgery.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Yonemura¹,

Endou

Shinbo

et al. 2009

Journal of Surgical Oncology

Self Cite

115

112

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“…The bidirectional / neoadjuvant intraperitoneal and systemic chemotherapy (BIPSC/NIPS), introduced by Yonemura et al [64] is a treatment schedule that aims at stage reduction, eradication of IFCC, and an increase in the incidence of complete cytoreduction [34]. The rationale of this method is to reduce tumour burden before surgery with NIPS, reduce macroscopic and microscopic PM with CRS & HIPEC and finally eradicate residual intraperitoneal cancer cells before the development of adhesions using EPIC.…”

Section: Nipsmentioning

confidence: 99%

“…The rationale of this method is to reduce tumour burden before surgery with NIPS, reduce macroscopic and microscopic PM with CRS & HIPEC and finally eradicate residual intraperitoneal cancer cells before the development of adhesions using EPIC. By simultaneously administering intravenous and intraperitoneal chemotherapy, the cancer cells are attacked both from the peritoneal cavity and from subperitoneal blood vessels [34,64].…”

Section: Nipsmentioning

confidence: 99%

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Seshadri

Gléhen

2016

Indian J Surg Oncol

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Peritoneal metastasis, either synchronous or metachronous, is commonly seen in gastric cancer. It is associated with a poor prognosis, with a median survival of less than one year. The outcomes are not significantly improved by the use of systemic chemotherapy. We review the relevant literature on the role of HIPEC in gastric cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used in three situations in gastric cancer. Besides its role as a definitive treatment in patients with established peritoneal metastasis (PM), it has been used as a prophylaxis against peritoneal recurrence after curative surgery and also as a palliative treatment in advanced peritoneal metastasis with intractable ascites. While prophylactic HIPEC has been shown to reduce peritoneal recurrence and improve survival in many randomised trials, palliative HIPEC can reduce the need for frequent paracentesis. Although CRS with HIPEC has shown promise in increasing the survival of selected patients with established PM from gastric cancer, larger studies are needed before this can be accepted as a standard of care.

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“…However, in Japan, the early research with peritoneal carcinomatosis from gastric primary, utilizing combination treatment with etoposide, mitomycin C, and cisplatin, has been reported [37,38]. Limited but definite benefits were demonstrated when palliative gastrectomy was combined with intraperitoneal heated multidrug treatment in gastric cancer patients with limited peritoneal seeding [8].…”

Section: Etoposidementioning

confidence: 99%

Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy

Sugarbaker¹,

Mora

Pablo³

et al. 2005

The Oncologist

155

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A new strategy currently under evaluation in patients with peritoneal carcinomatosis from gastrointestinal and gynecologic cancers is perioperative intraperitoneal chemotherapy. Although results to date show benefit to carefully selected groups of patients, continued local-regional failure is seen in many treated patients. Continued clinical and laboratory research efforts to improve local-regional effects are desired. The chemotherapeutic agents that have been used in the past or are currently being tested were reviewed. Their pharmacologic properties and clinical features were collected from the medical literature and are reviewed in the text. An organized presentation of available data concerning the drugs available for perioperative intraperitoneal chemotherapy for peritoneal surface malignancy was made. From this review, new possibilities for improved doses, schedules, and drug combinations for perioperative intraperitoneal chemotherapy may become important in future clinical studies. Continued optimal utilization of intraperitoneal chemotherapy treatments in the operating room with hyperthermia or normothermic treatment in the early postoperative period is desirable. Innovative treatment strategies can improve the outcome of patients with peritoneal surface malignancy. The Oncologist

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Effective therapy for peritoneal dissemination in gastric cancer

Cited by 75 publications

References 15 publications

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer

Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy

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