Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer

Jason J. Hall, Brian W. Loggie, Perry Shen, Staci Beamer, L. Douglas Case, Richard McQuellon, Kim R. Geisinger, Edward A. Levine

Research output: Contribution to journalArticle

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Abstract

Peritoneal carcinomatosis is a common and universally fatal sequelae of gastric carcinoma. Treatment of peritoneal carcinomatosis from appendiceal and colorectal sources with intraperitoneal hyperthermic chemotherapy (IPHC) combined with aggressive cytoreductive surgery has been shown to be effective. There are few data on this treatment modality for carcinoma of the stomach. This study evaluates cytoreductive surgery and IPHC with peritoneal carcinomatosis from gastric carcinoma. Thirty-four patients with peritoneal carcinomatosis due to gastric carcinoma underwent gastric resection with cytoreductive surgery followed by IPHC with mitomycin C. A control group consisting of 40 contemporaneous patients, who underwent radical gastrectomy without extended nodal resection, was identified through the tumor registry. Despite more advanced disease in the IPHC group compared to the control group (P <0.001), overall survival in the two groups was similar. Proportional-hazards regression analysis shows that only resection status is significantly correlated with improved survival (P=0.0068). Within the IPHC group, patients who underwent an R0/R1 resection had increased survival times (11.2 vs. 3.3 months, P=0.015) vs. those who underwent R2 resection. The group who had an R0/R1 resection had 1- and 2-year survival rates of 45% and 45% compared to 16% and 8%, respectively, in the R2 group. Cytoreductive surgery and IPHC is a modality with limited potential for the treatment of peritoneal carcinomatosis from gastric carcinoma. Careful patient selection for this procedure is imperative, and patients in whom an R0/R1 resection can be achieved are the best candidates.

Original languageEnglish
Pages (from-to)454-463
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume8
Issue number4
DOIs
StatePublished - May 2004

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Stomach Neoplasms
Carcinoma
Drug Therapy
Stomach
Survival
Control Groups
Mitomycin
Gastrectomy
Patient Selection
Registries
Therapeutics
Survival Rate
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

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Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer. / Hall, Jason J.; Loggie, Brian W.; Shen, Perry; Beamer, Staci; Case, L. Douglas; McQuellon, Richard; Geisinger, Kim R.; Levine, Edward A.

In: Journal of Gastrointestinal Surgery, Vol. 8, No. 4, 05.2004, p. 454-463.

Research output: Contribution to journalArticle

Hall, Jason J. ; Loggie, Brian W. ; Shen, Perry ; Beamer, Staci ; Case, L. Douglas ; McQuellon, Richard ; Geisinger, Kim R. ; Levine, Edward A. / Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer. In: Journal of Gastrointestinal Surgery. 2004 ; Vol. 8, No. 4. pp. 454-463.
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