Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience
Abstract Ashwin K.R. Introduction Peritoneal metastasis secondary to gastric cancer is associated with poor prognosis. Recent studies have shown that cytoreductive surgery (CRS) and hyperthermic intra...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-04-01
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| Series: | South Asian Journal of Cancer |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739176 |
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| author | Somashekhar S.P Jyothsana Karivedu Rohit Kumar C. Ramya Y. Priya Kapoor Amit Rauthan Ashwin K.R |
| author_facet | Somashekhar S.P Jyothsana Karivedu Rohit Kumar C. Ramya Y. Priya Kapoor Amit Rauthan Ashwin K.R |
| author_sort | Somashekhar S.P |
| collection | DOAJ |
| description | Abstract
Ashwin K.R.
Introduction Peritoneal metastasis secondary to gastric cancer is associated with poor prognosis. Recent studies have shown that cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may be an efficacious treatment option for an otherwise palliative condition.
Methods A retrospective single institutional study of patents diagnosed with gastric carcinoma and peritoneal metastasis and treated with CRS and HIPEC from February 2015 to December 2019.
Results Sixteen patients with gastric cancer and peritoneal carcinomatosis were treated with CRS and HIPEC. Three patients underwent upfront surgery, and five patients underwent interval surgery. The mean peritoneal cancer index (PCI) was 3.5, and adequate complete cytoreduction (CC) score of 0/1 was achieved in all patients. All patients received HIPEC with mitomycin C. Major surgical complications were in 12.5% of patients. Grade I surgical site infection was present in one patient. Three patients had prolonged gastrointestinal (GI) recovery. The 30-day mortality was zero. Median follow-up time was 39 months. The median progression-free survival (PFS) was 12 months (95% confidence interval [CI] 6.86–17.13). The median overall survival (OS) was 17 months (95% CI 6.36–27.64).
Conclusion Multidisciplinary treatment of perioperative chemotherapy with CRS and HIPEC is a promising treatment option, which may prolong survival in selected patients, and large randomized clinical trials are warranted for it to become standard of care. |
| first_indexed | 2024-04-13T11:40:54Z |
| format | Article |
| id | doaj.art-b789f0da462b43a88168833341a7a17a |
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| issn | 2278-330X 2278-4306 |
| language | English |
| last_indexed | 2024-04-13T11:40:54Z |
| publishDate | 2022-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | South Asian Journal of Cancer |
| spelling | doaj.art-b789f0da462b43a88168833341a7a17a2022-12-22T02:48:19ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2278-43062022-04-01110212112410.1055/s-0041-1739176Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian ExperienceSomashekhar S.P0Jyothsana Karivedu1Rohit Kumar C.2Ramya Y.3Priya Kapoor4Amit Rauthan5Ashwin K.R6Department of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, Karnataka, IndiaDepartment of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, Karnataka, IndiaDepartment of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, Karnataka, IndiaDepartment of Surgical Oncology, Apollo Hospital, Mysore, Karnataka, IndiaDepartment of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, Karnataka, IndiaDepartment of Medical Oncology, Manipal Comprehensive Cancer Center, Manipal hospital, Bangalore, Karnataka, IndiaDepartment of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, Karnataka, IndiaAbstract Ashwin K.R. Introduction Peritoneal metastasis secondary to gastric cancer is associated with poor prognosis. Recent studies have shown that cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may be an efficacious treatment option for an otherwise palliative condition. Methods A retrospective single institutional study of patents diagnosed with gastric carcinoma and peritoneal metastasis and treated with CRS and HIPEC from February 2015 to December 2019. Results Sixteen patients with gastric cancer and peritoneal carcinomatosis were treated with CRS and HIPEC. Three patients underwent upfront surgery, and five patients underwent interval surgery. The mean peritoneal cancer index (PCI) was 3.5, and adequate complete cytoreduction (CC) score of 0/1 was achieved in all patients. All patients received HIPEC with mitomycin C. Major surgical complications were in 12.5% of patients. Grade I surgical site infection was present in one patient. Three patients had prolonged gastrointestinal (GI) recovery. The 30-day mortality was zero. Median follow-up time was 39 months. The median progression-free survival (PFS) was 12 months (95% confidence interval [CI] 6.86–17.13). The median overall survival (OS) was 17 months (95% CI 6.36–27.64). Conclusion Multidisciplinary treatment of perioperative chemotherapy with CRS and HIPEC is a promising treatment option, which may prolong survival in selected patients, and large randomized clinical trials are warranted for it to become standard of care.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739176cytoreductive surgeryhyperthermic intraperitoneal chemotherapygastric cancerperitoneal carcinomatosispalliative chemotherapy |
| spellingShingle | Somashekhar S.P Jyothsana Karivedu Rohit Kumar C. Ramya Y. Priya Kapoor Amit Rauthan Ashwin K.R Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience South Asian Journal of Cancer cytoreductive surgery hyperthermic intraperitoneal chemotherapy gastric cancer peritoneal carcinomatosis palliative chemotherapy |
| title | Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience |
| title_full | Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience |
| title_fullStr | Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience |
| title_full_unstemmed | Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience |
| title_short | Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer with Peritoneal Metastasis—Indian Experience |
| title_sort | cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis indian experience |
| topic | cytoreductive surgery hyperthermic intraperitoneal chemotherapy gastric cancer peritoneal carcinomatosis palliative chemotherapy |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739176 |
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