BACKGROUND: The treatment options for the 10-20 per cent of patients with gastric cancer who present with peritoneal dissemination are extremely limited and no standard approach exists. METHODS: The feasibility of using intraperitoneal chemotherapy to treat gastric cancer with intra-abdominal gross residual lesions after palliative gastrectomy with maximal cytoreduction was investigated. Early postoperative intraperitoneal chemotherapy started on the day of operation with 5-fluorouracil 500 mg/m2 and cisplatin 40 mg/m2 (days 1-3) over a 4-week interval. RESULTS: Of the 53 patients enrolled between July 1994 and December 1998, 49 were eligible. The progression-free survival (PFS) was 7 months and the overall survival was 12 months. In multivariate analysis, performance status was the only significant defining factor for PFS (P = 0.009). The predominant toxicity was neutropenia and nausea/vomiting. The relative dose intensity of 5-fluorouracil and cisplatin was 89 and 63 per cent respectively. CONCLUSION: Performance status emerged as a major determining factor for prognosis and patient selection for early postoperative intraperitoneal chemotherapy in patients with advanced gastric cancer after maximally cytoreductive surgery.
BACKGROUND: The treatment options for the 10-20 per cent of patients with gastric cancer who present with peritoneal dissemination are extremely limited and no standard approach exists. METHODS: The feasibility of using intraperitoneal chemotherapy to treat gastric cancer with intra-abdominal gross residual lesions after palliative gastrectomy with maximal cytoreduction was investigated. Early postoperative intraperitoneal chemotherapy started on the day of operation with 5-fluorouracil 500 mg/m2 and cisplatin 40 mg/m2 (days 1-3) over a 4-week interval. RESULTS: Of the 53 patients enrolled between July 1994 and December 1998, 49 were eligible. The progression-free survival (PFS) was 7 months and the overall survival was 12 months. In multivariate analysis, performance status was the only significant defining factor for PFS (P = 0.009). The predominant toxicity was neutropenia and nausea/vomiting. The relative dose intensity of 5-fluorouracil and cisplatin was 89 and 63 per cent respectively. CONCLUSION: Performance status emerged as a major determining factor for prognosis and patient selection for early postoperative intraperitoneal chemotherapy in patients with advanced gastric cancer after maximally cytoreductive surgery.
Authors: Kyung Jai Ko; Jung Ho Shim; Han Mo Yoo; Seong Il O; Hae Myung Jeon; Cho Hyun Park; Dong Jin Jeon; Kyo Young Song Journal: World J Surg Date: 2012-08 Impact factor: 3.352
Authors: Abeezar I Sarela; Thomas J Miner; Martin S Karpeh; Daniel G Coit; David P Jaques; Murray F Brennan Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
Authors: John Syrios; Stavros Sougioultzis; Ioannis D Xynos; Nikolaos Kavantzas; Christos Kosmas; George Agrogiannis; John Griniatsos; Ioannis Karavokyros; Emmanouil Pikoulis; Efstratios S Patsouris; Nikolas Tsavaris Journal: BMC Cancer Date: 2012-06-21 Impact factor: 4.430