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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2007

01-01-2007

Early Postoperative Intraperitoneal Chemotherapy Following Cytoreductive Surgery in Patients with Very Advanced Gastric Cancer

Authors: Jae-Ho Cheong, MD, Jia Yun Shen, MD, Chang Soo Song, MD, Woo Jin Hyung, MD, Jian Guo Shen, MD, Seung Ho Choi, MD, Sung Hoon Noh, MD

Published in: Annals of Surgical Oncology | Issue 1/2007

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Abstract

Background

The survival of patients with stage IV gastric cancer is poor due to frequent peritoneal failure. The aim of this study was to investigate the impact of early postoperative intraperitoneal chemotherapy (EPIC) after cytoreductive surgery on the long-term survival of these patients, as determined by residual disease status.

Methods

A total of 154 patients with stage IV gastric cancer were enrolled in our study. All patients underwent potentially curative or palliative resections. After surgery, the residual disease states of the patients were recorded. All patients received EPIC.

Results

Of all 154 patients, R0 resection was achieved in 37, R1 in 56, and R2 in 61. All patients received a mean of 4.3 EPIC perfusions. After a mean followup period of 29 months, 14 patients remained alive. The median survival of all 154 patients was 11.4 months. Survival times were analyzed according to the type of residual tumor; the median survival time was 25.5 months in the R0 group, 15.6 months in the R1 group, and 7.2 months in the R2 group (p < .001). Upon multivariate analysis, the residual tumor states and the cycle of EPIC perfusion were found to be independent prognostic predictors (p < .001 and p = .018, respectively).

Conclusions

The residual tumor status is the most important predictor for the survival of very advanced gastric cancer patients who received cytoreductive surgery and EPIC. Therefore, complete cytoreductive surgery yielding R0 resection is mandatory for achieving the beneficial effects of EPIC.
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Metadata
Title
Early Postoperative Intraperitoneal Chemotherapy Following Cytoreductive Surgery in Patients with Very Advanced Gastric Cancer
Authors
Jae-Ho Cheong, MD
Jia Yun Shen, MD
Chang Soo Song, MD
Woo Jin Hyung, MD
Jian Guo Shen, MD
Seung Ho Choi, MD
Sung Hoon Noh, MD
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9205-7

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