Cytoreduction and Hyperthermic Intraperitoneal Paclitaxel and Cisplatin for Gastric Cancer with Peritoneal Metastasis

被引:6
作者
Buckarma, Eeeln [1 ]
Thiels, Cornelius A. [1 ]
Jin, Zhaohui [2 ]
Grotz, Travis E. [1 ]
机构
[1] Mayo Clin, Dept Surg, Div Hepatobiliary & Pancreas Surg, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Med Oncol, GI Care Team, Rochester, MN USA
关键词
Gastric cancer; Peritoneal metastasis; Intraperitoneal chemotherapy; Cytoreduction surgery; HIPEC; SCHEDULE-DEPENDENT INTERACTION; SYNERGISTIC ANTITUMOR-ACTIVITY; MITOMYCIN-C; CHEMOTHERAPY; CARCINOMATOSIS; SURGERY; ADENOCARCINOMA; 5-FLUOROURACIL; GASTRECTOMY; DOXORUBICIN;
D O I
10.1245/s10434-023-14379-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundPeritoneal metastasis (PM) is the most common site of dissemination of gastric cancer (GC) and is associated with a poor prognosis. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for GC with PM remains controversial due to modest survival and significant morbidity.MethodsWe conducted a retrospective analysis of patients with GC and PM treated with CRS and HIPEC with cisplatin and paclitaxel for 90 min from June 2019 to December 2022.ResultsTwenty-two patients were included and received a median of 7 (interquartile range [IQR] 4-8) cycles of neoadjuvant systemic therapy. Seventeen patients (77%) underwent a single neoadjuvant laparoscopic HIPEC, and six (27%) patients received chemoradiation. The median Peritoneal Carcinomatosis Index at the time of CRS was 1 (IQR 0-4), and 21 patients (95%) underwent complete cytoreduction (CC-0). An R0 resection was achieved in 20 (91%) patients, and the median length of stay was 5.5 (IQR 4-7.5) days. There were six (27%) 90-day major complications (Clavien-Dindo grade >= 3), one (4%) Common Terminology Classification for Adverse Events (CTCAE) grade 4 cytopenia, and one (4%) acute kidney injury. The rate of anastomotic leak (all grades) was 14%, the 30-day readmission rate was 18%, and the 90-day mortality rate was 0%. At a median follow-up of 24 months, the median progression-free survival (PFS) and overall survival (OS) were not reached. The 1-, 2-, and 3-year PFS rates were 65%, 56%, and 40%, respectively, and the 1-, 2-, and 3-year OS rates were 96%, 78%, and 55%, respectively.ConclusionsCRS and HIPEC with paclitaxel and cisplatin is well tolerated and is associated with favorable oncologic and perioperative outcomes.
引用
收藏
页码:622 / 629
页数:8
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