The Burden of Peritoneal Metastases from Gastric Cancer: A Systematic Review on the Incidence, Risk Factors and Survival

Abstract

The peritoneum is a common metastatic site in gastric cancer. This systematic review provides an overview of the incidence, risk factors and survival of synchronous peritoneal metastases from gastric cancer. A systematic search was performed to identify studies wherein the incidence, risk factors and survival of gastric cancer with peritoneal metastases were investigated. Of all 38 potentially eligible studies, 17 studies were included based on the eligibility criteria. The incidence of synchronous gastric peritoneal metastases was reviewed for population-based studies (10–21%), for observational cohort studies (2–15%) and for surgical cohort studies (13–40%). Potential risk factors for synchronous gastric peritoneal metastases were younger age, non-cardia gastric cancer, female sex, signet ring cell carcinoma, diffuse type histology or linitis plastica, T4 stage, Hispanic ethnicity and more than one metastatic location. Synchronous peritoneal metastases are commonly diagnosed in patients with gastric cancer with an incidence up to 21% in recent population-based studies. Furthermore, prognosis of patients with gastric peritoneal metastases is poor with median overall survival ranging from 2 to 9 months. The high incidence and poor prognosis require intensive research on diagnostic features and effective treatment options to improve survival.

Sex and gender disparities in patients with advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

“…No differences were observed with respect to the number of metastatic sites. Given that the pattern of peritoneal dissemination is associated with diffuse histology and signet ring cells, we identified a higher incidence of peritoneal metastases 35 and, given the proportions of histological type and peritoneal dissemination in our series, we can explain the differences in the pattern of dissemination as a consequence of histopathological characteristics ( Table 1 ). An evaluation of metastatic sites, liver tumor burden, ascites, and peritoneal carcinomatosis suggests that the higher percentage of females with very high tumor burden is especially dictated by the peritoneal involvement.…”

Claudin18.2-specific CAR T cells in gastrointestinal cancers: phase 1 trial interim results

“…In contrast, the KEYNOTE-059 study treated only 2.7% patients with signet-ring cell carcinoma. In addition, patients with GC and peritoneal metastases have an overall survival ranging from 2 months to 9 months 25 , although advances in combination intraperitoneal and systemic chemotherapy administration may offer future improvement 26 . This may, in part, be due to limited penetration of systemic administration of anticancer drugs to peritoneal carcinomas 27 .…”

Primary and metastatic peritoneal surface malignancies

“…Although the incidence of gastric cancer is the highest in East Asia (Japan and Mongolia) and Eastern Europe, specific reporting of the incidence of peritoneal metas tases from gastric cancer from these regions remains scarce 14 . In a registry study from the Netherlands, peritoneal metastasis was detected in 14% of gastric cancers at the time of initial diagnosis, with a median survival time of 4 months 24,25 . For colorectal cancer, the relative incidence of synchronous peritoneal metastases is 4-15% 16,26 .…”