Effects of neoadjuvant laparoscopic hyperthermic intraperitoneal chemoperfusion and intraperitoneal/systemic chemotherapy on peritoneal metastasis from gastric cancer

Authors

  • Yutaka Yonemura NPO to Support Peritoneal Surface Malignancy Treatment, Japan; Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Emel Canbay NPO to Support Peritoneal Surface Malignancy Treatment
  • Takuji Fujita NPO to Support Peritoneal Surface Malignancy Treatment, Japan; Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Shouszou Sako NPO to Support Peritoneal Surface Malignancy Treatment, Japan; Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Satoshi Wakama Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Haruaki Ishibashi Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Masamitu Hirano Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Akiyoshi Mizumoto Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Kazuyoshi Takeshita NPO to Support Peritoneal Surface Malignancy Treatment, Japan; Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Nobuyuki Takao Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Masumi Ichinose Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Kousuke Noguchi Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga
  • Yang Liu Department of Regional Cancer therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada
  • Yan Li Department of Peritoneal Surface Oncology, Beijin Shijitan Hospital of Capital Medical University, Beijin
  • Keizou Taniguchi Department of Surgery, Mizoguichi Hospital, Teikyou University

DOI:

https://doi.org/10.4081/joper.2017.60

Keywords:

Gastric cancer, peritoneal metastasis, Peritoneal metastasis, hyperthermic intraperitoneal chemoperfusion, Hyperthermic intraperitoneal chemoperfusion, laparoscopy, Laparoscopy, peritoneal cancer index, Peritoneal cancer index

Abstract

Our aim was to clarify the effects of neoadjuvant hyperthermic intraperitoneal chemoperfusion (NLHIPEC) followed by intraperitoneal/systemic chemotherapy (NIPS) on peritoneal metastasis from gastric cancer. After carrying out exploratory laparoscopy to determine the peritoneal cancer index (pretreatment PCI: Pre-PCI) in 150 patients, we performed NLHIPEC for 60 min. with peritoneal port placement: a series of 3-week cycles of NIPS using S1, docetaxel, and cisplatin two weeks after NLHIPEC: performed cytoreductive surgery in 86 patients four weeks after NIPS, and subsequently measured PCI (Post-PCI). Positive cytology in 38 patients changed to negative in 26 (68.4%) patients at laparotomy. The post-PCI (6.7±7.8) was significantly lower than the pre-PCI (10.6±10.2) (P=0.0001). The PCI was ≥14 in 30 patients at pretreatment and ≤13 in 19 (63.3ô€€) of these patients at posttreatmjent. Post-PCI cut-off level (≤13 vs ≥14) and cytology after NIPS (negative vs positive) emerged as independent indicators of prognosis. Postoperative mortality was 1.2% (1/86). NLHIPEC and NIPS are safe and effective modalities for reducing Post-PCI below the cut-off level and eradicating peritoneal free cancer cells.

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Published

2017-07-31

How to Cite

1.
Yonemura Y, Canbay E, Fujita T, Sako S, Wakama S, Ishibashi H, Hirano M, Mizumoto A, Takeshita K, Takao N, Ichinose M, Noguchi K, Liu Y, Li Y, Taniguchi K. Effects of neoadjuvant laparoscopic hyperthermic intraperitoneal chemoperfusion and intraperitoneal/systemic chemotherapy on peritoneal metastasis from gastric cancer. J Peritoneum [Internet]. 2017 Jul. 31 [cited 2024 Dec. 22];2(2). Available from: https://joper.pagepress.net/index.php/joper/article/view/60

Issue

Vol 2, No 2 (2017)

Section

Original Articles from PSOGI Congress

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