Beate Rau1, Andreas Brandl2, Pompiliu Piso3, Jörg Pelz4, Peter Busch5, Cedric Demtröder6, Silke Schüle7, Hans-Jürgen Schlitt8, Marc Roitman9, Jürgen Tepel10, Udo Sulkowski11, Faik Uzunoglu12, Michael Hünerbein13, Rüdiger Hörbelt14, Michael Ströhlein15, Stefan Beckert16, Ingmar Königsrainer16, Alfred Königsrainer16. 1. Department of Surgery, Campus Virchow-Klinikum and Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. beate.rau@charite.de. 2. Department of Surgery, Campus Virchow-Klinikum and Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. 3. Department of General and Visceral Surgery, Barmherzige Brueder Hospital Regensburg, Regensburg, Germany. 4. Department of General, Visceral, and Oncologic Surgery, St. Bernward Hospital, Hildesheim, Germany. 5. Department of Visceral, General Surgery, Agatharied Hospital, Hausham, Germany. 6. Department of General Surgery and Therapy Center for Peritoneal Carcinomatosis, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany. 7. Department of General, Visceral and Vascular Surgery, University Hospital of Jena, Jena, Germany. 8. Department of Surgery, University Hospital Regensburg, Regensburg, Germany. 9. Surgical Center and Asklepios Tumor Center, Asklepios Paulinen Klinik, Wiesbaden, Germany. 10. Clinic for General, Thoracic and Visceral Surgery, Klinikum Osnabrück, Osnabrück, Germany. 11. Department of General, Visceral and Vascular Surgery, Clemenshospital, Münster, Germany. 12. Department of General, Visceral and Thoracic Surgery, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany. 13. Department of General, Visceral and Cancer Surgery, HELIOS Klinikum Berlin-Buch, Berlin, Germany. 14. Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital Gießen, Gießen, Germany. 15. Department of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, Cologne, Germany. 16. Department of Surgery, Comprehensive Cancer Center, University of Tübingen, Tübingen, Germany.
Abstract
BACKGROUND: Patients with peritoneal metastases of gastric cancer have a poor prognosis with a median survival of 7 months. A benefit of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could be shown in several selected patient cohorts but remains controversial. The aim of this study was, to reflect the results of a national German HIPEC registry initiated by the German Society of General and Visceral Surgery (DGAV). METHODS: The DGAV HIPEC registry StuDoQ|Peritoneum documents patients with peritoneal malignancy contributed from 52 hospitals. All consecutive documented patients from 2011 until 2016 (n = 3078) were treated with CRS and HIPEC and were analysed. A total of 315 (10%) suffered from gastric cancer and were analysed. RESULTS: A complete data set of 235 patients was available for this study, including 113 male (48.1%) and 122 female (51.9%) patients with a median age of 53.4 years (SD ± 11.9). The median PCI was 8.0 (range 1-30). A complete cytoreduction was achieved in 121 patients (71.6%). Postoperative complications (Clavien-Dindo grades 3-4) occurred in 40 patients (17%). The median overall survival (OS) time was 13 months. The 5-year survival rate was 6%. According to the PCI from 0-6 (n = 74); 7-15 (n = 70) and 16-39 (n = 24) the median OS differs significantly (18 months vs. 12 months vs. 5 months; p = 0.002). CONCLUSIONS: CRS and HIPEC in selected patients with gastric cancer and peritoneal spread can improve survival when they are treated in centers. An accurate staging and patient selection are of major importance to achieve long-term survival.
BACKGROUND:Patients with peritoneal metastases of gastric cancer have a poor prognosis with a median survival of 7 months. A benefit of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could be shown in several selected patient cohorts but remains controversial. The aim of this study was, to reflect the results of a national German HIPEC registry initiated by the German Society of General and Visceral Surgery (DGAV). METHODS: The DGAV HIPEC registry StuDoQ|Peritoneum documents patients with peritoneal malignancy contributed from 52 hospitals. All consecutive documented patients from 2011 until 2016 (n = 3078) were treated with CRS and HIPEC and were analysed. A total of 315 (10%) suffered from gastric cancer and were analysed. RESULTS: A complete data set of 235 patients was available for this study, including 113 male (48.1%) and 122 female (51.9%) patients with a median age of 53.4 years (SD ± 11.9). The median PCI was 8.0 (range 1-30). A complete cytoreduction was achieved in 121 patients (71.6%). Postoperative complications (Clavien-Dindo grades 3-4) occurred in 40 patients (17%). The median overall survival (OS) time was 13 months. The 5-year survival rate was 6%. According to the PCI from 0-6 (n = 74); 7-15 (n = 70) and 16-39 (n = 24) the median OS differs significantly (18 months vs. 12 months vs. 5 months; p = 0.002). CONCLUSIONS: CRS and HIPEC in selected patients with gastric cancer and peritoneal spread can improve survival when they are treated in centers. An accurate staging and patient selection are of major importance to achieve long-term survival.
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