Treatment options in synchronous peritoneal metastasis from gastric cancer: A retrospective cohort analysis
1 Department of Surgery and Surgical Oncology, European Interbalkan Medical Center, Thessaloniki, Greece.
2 Department of Surgery and Surgical Oncology, Athens Medical Center, Athens, Greece.
Research Article
World Journal of Advanced Research and Reviews, 2022, 16(02), 504–507
Article DOI: 10.30574/wjarr.2022.16.2.1195
Publication history:
Received on 02 October 2022; revised on 08 November 2022; accepted on 11 November 2022
Abstract:
Gastric cancer (GC) is a common malignancy and one of the leading causes of cancer related death. Peritoneal metastases (PM) are not uncommon and then prognosis is poor. Treatment options in these cases are not standardized. The use of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) represents an option in selected patients.
We retrospectively analyzed our prospectivey collected peritoneal surface malignancy database and assessed patients with synchronous peritoneal metastases from gastric primary based on peritoneal cancer index (PCI).
Over a 16 year period, 600 such patients were identified. They were divided into 5 treatment groups based on their PCI. Surgical morbidity ranged from 5 to 22% and mortality from 1.4 to 3.8%. Overall survival was 7.3 months (range 3.9-14.8). PCI was an independent factor for increased overall survival and the most important factor for treatment decision making.
Generally, patients with GC associated PM have poor prognosis. CRS and HIPEC can offer a survival benefit in carefully selected patients. Long-term survival was observed in patients with PCI≤7. Non-surgical approach can be equally effective for more advanced disease and palliative chemotherapy can offer a better quality of life.
Keywords:
Gastric cancer; Peritoneal metastases; HIPEC; Cytoreductive surgery
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