Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Despite advances in targeted therapies, the prognosis for patients with peritoneal metastases (PM) from gastric cancer remains poor, due to the "blood-peritoneal barrier," which limits delivery of systemically administered drugs to peritoneal lesions. Intraperitoneal (IP) administration of paclitaxel (PTX) offers pharmacokinetic advantages by enhancing drug retention and infiltration in peritoneal lesions. Normothermic intraperitoneal and systemic chemotherapy (NIPS), developed in Japan two decades ago, combines repeated IP infusion of PTX via an intraperitoneal access port with systemic chemotherapy, and is currently regarded as one of the most effective treatment modalities for managing PM from gastric cancer. This review provides an overview of the theoretical rationale and clinical outcomes associated with this treatment strategy.

Despite advances in targeted therapies, the prognosis for patients with peritoneal metastases (PM) from gastric cancer remains poor, due to the "blood-peritoneal barrier," which limits delivery of systemically administered drugs to peritoneal lesions. Intraperitoneal (IP) administration of paclitaxel (PTX) offers pharmacokinetic advantages by enhancing drug retention and infiltration in peritoneal lesions. Normothermic intraperitoneal and systemic chemotherapy (NIPS), developed in Japan two decades ago, combines repeated IP infusion of PTX via an intraperitoneal access port with systemic chemotherapy, and is currently regarded as one of the most effective treatment modalities for managing PM from gastric cancer. This review provides an overview of the theoretical rationale and clinical outcomes associated with this treatment strategy.

This study investigated the clinical effect of metformin on breast cancer patients with preexisting type 2 diabetes mellitus (T2DM). We analyzed 177 patients with T2DM who underwent breast cancer surgery and assessed tumor-associated macrophages (TAMs) and tumor-infiltrating lymphocytes (TILs) in patients who underwent tumor resection with or without metformin treatment using multiplex immunohistochemistry (IHC). Patients who received metformin either pre- or postoperatively exhibited reduced distant organ recurrence and improved postoperative recurrence-free survival compared to those of patients who did not. Additionally, in a subgroup of 40 patients receiving preoperative systemic therapy, metformin treatment was associated with increased rates of pathological complete response.IHC analysis revealed significantly lower levels of cluster of differentiation (CD) 68(+) CD163(+) M2-type TAMs (p < 0.01) but higher CD3(+) and CD8(+) TIL densities in the metformin-treated group compared with the same parameters in those without metformin treatment, with a significant difference in the CD8(+)/CD3(+) TIL ratio (p < 0.01). Despite the constraints posed by our small sample size, our findings suggest a potential role for metformin in modulating the immunological microenvironment, which may contribute to improved outcomes in diabetes patients with breast cancer.