Recent progress and future prospects of treatment for peritoneal metastasis in gastric cancer.
10.3760/cma.j.cn441530-20230301-00059
- Author:
Yan XU
1
;
Zhen Ning WANG
1
Author Information
1. Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, Shenyang 110001, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Stomach Neoplasms/pathology*;
Peritoneal Neoplasms/secondary*;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Hyperthermia, Induced/methods*;
Peritoneum/pathology*;
Combined Modality Therapy;
Cytoreduction Surgical Procedures/methods*;
Survival Rate
- From:
Chinese Journal of Gastrointestinal Surgery
2023;26(5):414-418
- CountryChina
- Language:Chinese
-
Abstract:
Peritoneal metastasis is one of the most frequent patterns of metastasis in gastric cancer, and remains a major unmet clinical problem. Thus, systemic chemotherapy remains the mainstay of treatment for gastric cancer with peritoneal metastasis. In well-selected patients, the reasonable combination of cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and neoadjuvant intraperitoneal chemotherapy with systemic chemotherapy will bring significant survival benefits to patients with gastric cancer peritoneal metastasis. In patients with high-risk factors, prophylactic therapy may reduce the risk of peritoneal recurrence, and improves survival after radical gastrectomy. However, high-quality randomized controlled trials will be needed to determine which modality is better. The safety and efficacy of intraoperative extensive intraperitoneal lavage as a preventive measure has not been proven. The safety of HIPEC also requires further evaluation. HIPEC and neoadjuvant intraperitoneal and systemic chemotherapy have achieved good results in conversion therapy, and it is necessary to find more efficient and low-toxicity therapeutic modalities and screen out the potential benefit population. The efficacy of CRS combined with HIPEC on peritoneal metastasis in gastric cancer has been preliminarily validated, and with the completion of clinical studies such as PERISCOPE II, more evidence will be available.
