Neoadjuvant treatment of gastric cancer with peritoneal dissemination

Yonemura, Yutaka; Bandou, Etsurou; Sawa, Toshiharu; Yoshimitsu, Yutaka; Endou, Yoshio; Sasaki, Takuma; Sugarbaker, Paul H.

doi:10.1016/j.ejso.2006.03.007

Cited by 122 publications

(105 citation statements)

References 19 publications

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“…It shows true heat synergy, with 5-to 10-times the duration of tumour control with 41.5°C heat compared to normal temperatures [28]. Its anti-cancer effects only occur after it is metabolised in the liver and red blood cells to form 4-hydroxyifosfamide [26].…”

Section: Bidirectional Chemotherapymentioning

confidence: 99%

“…NIPS is an intravenous and intraperitoneal chemotherapy regimen given as an option for reducing the tumour load prior to CRS and therefore may even facilitate definitive CRS [28]. Radiological and clinical responses with NIPS have been reported by several groups [28][29][30].…”

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

“…Radiological and clinical responses with NIPS have been reported by several groups [28][29][30]. However, disadvantages include non-uniform intraperitoneal drug distribution due to adhesions and it is also associated with an increased morbidity and mortality on further surgical intervention as extensive fibrosis can also occur, which can interfere with surgical judgement [31].…”

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

“…However, disadvantages include non-uniform intraperitoneal drug distribution due to adhesions and it is also associated with an increased morbidity and mortality on further surgical intervention as extensive fibrosis can also occur, which can interfere with surgical judgement [31]. NIPS is a promising approach that may be of benefit in the management of peritoneal metastases from gastric cancer [28].…”

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

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Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Valle

Alzahrani

Sugarbaker

et al. 2016

Indian J Surg Oncol

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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) combined have been recognized as standard of care for treatment of a subset of patients with peritoneal carcinomatosis (PC). The aim of CRS is to eliminate all macroscopic disease through a series of visceral resections followed by targeting any residual microscopic disease with intraperitoneal chemotherapy, exposing the peritoneal surfaces to a high concentration of chemotherapy with a lower systemic toxicity. Different regimes of intraperitoneal chemotherapy include HIPEC, early postoperative intraperitoneal chemotherapy (EPIC) and bidirectional chemotherapy. The efficacy and modality of treatment with intraperitoneal chemotherapy is dependent on multiple factors including the chosen cytotoxic agent and its pharmacokinetics and pharmacodynamics. There is no standardized methodology for intraperitoneal chemotherapy administration. This review will discuss the pharmacological principles of the various intraperitoneal chemotherapy techniques.

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Section: Bidirectional Chemotherapymentioning

confidence: 99%

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

Section: Neoadjuvant Intraperitoneal and Systemic Chemotherapy (Nips)mentioning

confidence: 99%

See 2 more Smart Citations

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Methodology, Drugs and Bidirectional Chemotherapy

Valle

Alzahrani

Sugarbaker

et al. 2016

Indian J Surg Oncol

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“…A new type of neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) has been developed to increase the rate of complete cytoreduction. (4) The complete removal of peritoneal dissemination is an independent prognostic factor. A peritonectomy is a novel surgical procedure by which complete cytoreduction for peritoneal dissemination is performed.…”

mentioning

confidence: 99%

Recent advances in the treatment of peritoneal dissemination of gastrointestinal cancers by nucleoside antimetabolites

et al. 2006

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Peritoneal dissemination is the most common cause of metastasis from malignancies in the abdominal cavity. There are no standard treatments for peritoneal dissemination and the results are poor. The reasons for this are as follows: (1) no effective chemotherapeutic agents have been identified or developed; (2) surgical cytoreduction has little effect on survival improvement; and (3) the molecular mechanisms of peritoneal dissemination have not been clarified and no therapy against the target molecules has been developed. However, studies on the molecular mechanisms of peritoneal dissemination have elucidated some of the target molecules and the development of new multimodal therapies has also improved survival. Early postoperative intraperitoneal chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and neoadjuvant intraperitoneal-systemic chemotherapy have been newly developed, and a novel surgical therapy named peritonectomy has been proposed to perform complete cytoreduction of peritoneal dissemination. At present, these approaches appear to be effective therapeutic modalities for peritoneal dissemination. However, TS-1 and capecitabine have shown worthwhile results in recent clinical trials for patients with advanced gastric cancer. We recently found that newly developed antitumor cytosine nucleoside analogs show a survival advantage in peritoneal dissemination models using human cancer cells. These non-fluoropyrimidine nucleosides may potentially help to improve the poor prognosis observed in patients with advanced cancers involving peritoneal dissemination. (Cancer Sci 2007; 98: 11-18) P eritoneal dissemination remains the most difficult type of metastasis to treat, and almost all surgeons believe that an operation is not indicated for such metastasis.(1-3) Systemic chemotherapy tends to have little effect on the treatment of peritoneal dissemination, because the peritoneal-blood barrier existing between mesothelial cells and the submesothelial capillary hinders drug distribution throughout the peritoneal cavity. Recent advances in the studies of new drugs and multimodal therapies have proposed the therapeutic potency for advanced cancer with peritoneal dissemination. Neoadjuvant chemotherapy is also known to reduce the tumor burden, thus resulting in a stage reduction. As a result, the incidence of complete cytoreduction may increase after neoadjuvant chemotherapy. A new type of neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) has been developed to increase the rate of complete cytoreduction. The complete removal of peritoneal dissemination is an independent prognostic factor. A peritonectomy is a novel surgical procedure by which complete cytoreduction for peritoneal dissemination is performed.(5-8) These approaches are now being carried out as treatment modalities for peritoneal dissemination from appendiceal, colon and gastric cancer. Furthermore, several recent phase II studies that evaluated the efficacy of new anticancer drugs including taxanes, TS-1 and capecitabine have shown p...

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