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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2010

01-09-2010 | Gastrointestinal Oncology

Peritoneal Carcinomatosis from Gastric Cancer: A Multi-Institutional Study of 159 Patients Treated by Cytoreductive Surgery Combined with Perioperative Intraperitoneal Chemotherapy

Authors: Olivier Glehen, MD, PhD, François Noel Gilly, MD, PhD, Catherine Arvieux, MD, PhD, Eddy Cotte, MD, Florent Boutitie, Baudouin Mansvelt, MD, PhD, Jean Marc Bereder, MD, Gérard Lorimier, MD, François Quenet, MD, Dominique Elias, MD, PhD, Association Française de Chirurgie

Published in: Annals of Surgical Oncology | Issue 9/2010

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Abstract

Background

Peritoneal carcinomatosis (PC) from gastric cancer has long been regarded a terminal disease with a short median survival. New locoregional therapeutic approaches combining cytoreductive surgery with perioperative intraperitoneal chemotherapy (PIC) have evolved and suggest improved survival.

Materials and Methods

A retrospective multicentric study was performed in French-speaking centers to evaluate the toxicity and the principal prognostic factors in order to identify the best indications. All patients had cytoreductive surgery and PIC: hyperthermic intraperitoneal chemotherapy (HIPEC) and/or early postoperative intraperitoneal chemotherapy (EPIC).

Results

The study included 159 patients from 15 institutions between February 1989 and August 2007. The median follow-up was 20.4 months. HIPEC was the PIC used for 150 procedures. Postoperative mortality and grade 3–4 morbidity rates were 6.5 and 27.8%, respectively. By multivariate analysis, the institution had a significant influence on toxicity. The overall median survival was 9.2 months and 1-, 3-, and 5-year survival rates were 43, 18, and 13%, respectively. The only independent prognostic indicator by multivariate analysis was the completeness of cytoreductive surgery. For patients treated by complete cytoreductive surgery, the median survival was 15 months with a 1-, 3-, and 5-year survival rate of 61, 30, and 23%, respectively.

Conclusions

The therapeutic approach combining cytoreductive surgery with PIC for patients with gastric carcinomatosis may achieve long-term survival in a selected group of patients (limited and resectable PC). The high mortality rate underlines this necessarily strict selection that should be reserved to experienced institutions involved in the management of PC and gastric surgery.
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Metadata
Title
Peritoneal Carcinomatosis from Gastric Cancer: A Multi-Institutional Study of 159 Patients Treated by Cytoreductive Surgery Combined with Perioperative Intraperitoneal Chemotherapy
Authors
Olivier Glehen, MD, PhD
François Noel Gilly, MD, PhD
Catherine Arvieux, MD, PhD
Eddy Cotte, MD
Florent Boutitie
Baudouin Mansvelt, MD, PhD
Jean Marc Bereder, MD
Gérard Lorimier, MD
François Quenet, MD
Dominique Elias, MD, PhD
Association Française de Chirurgie
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 9/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1039-7

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