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Early Postoperative Intraperitoneal Chemotherapy Following Cytoreductive Surgery in Patients with Very Advanced Gastric Cancer

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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The survival of patients with stage IV gastric cancer is poor due to frequent peritoneal failure. The aim of this study was to investigate the impact of early postoperative intraperitoneal chemotherapy (EPIC) after cytoreductive surgery on the long-term survival of these patients, as determined by residual disease status.

Methods

A total of 154 patients with stage IV gastric cancer were enrolled in our study. All patients underwent potentially curative or palliative resections. After surgery, the residual disease states of the patients were recorded. All patients received EPIC.

Results

Of all 154 patients, R0 resection was achieved in 37, R1 in 56, and R2 in 61. All patients received a mean of 4.3 EPIC perfusions. After a mean followup period of 29 months, 14 patients remained alive. The median survival of all 154 patients was 11.4 months. Survival times were analyzed according to the type of residual tumor; the median survival time was 25.5 months in the R0 group, 15.6 months in the R1 group, and 7.2 months in the R2 group (p < .001). Upon multivariate analysis, the residual tumor states and the cycle of EPIC perfusion were found to be independent prognostic predictors (p < .001 and p = .018, respectively).

Conclusions

The residual tumor status is the most important predictor for the survival of very advanced gastric cancer patients who received cytoreductive surgery and EPIC. Therefore, complete cytoreductive surgery yielding R0 resection is mandatory for achieving the beneficial effects of EPIC.

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Acknowledgments

This work was supported by the Korea Science and Engineering Foundation (KOSEF) through the Cancer Metastasis Research Center (CMRC) at Yonsei University College of Medicine.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, Seoul, 120-752, Korea

    Jae-Ho Cheong MD, Jia Yun Shen MD, Chang Soo Song MD, Woo Jin Hyung MD, Jian Guo Shen MD, Seung Ho Choi MD & Sung Hoon Noh MD

  2. Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul, 120-752, Korea

    Jae-Ho Cheong MD, Chang Soo Song MD, Woo Jin Hyung MD & Sung Hoon Noh MD

  3. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, 120-752, Korea

    Sung Hoon Noh MD

  4. Department of Surgical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016, China

    Jia Yun Shen MD & Jian Guo Shen MD

  5. Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong Seodaemun-gu, Seoul, 120-752, Korea

    Sung Hoon Noh MD

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  1. Jae-Ho Cheong MD
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  2. Jia Yun Shen MD
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  3. Chang Soo Song MD
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  4. Woo Jin Hyung MD
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  5. Jian Guo Shen MD
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  6. Seung Ho Choi MD
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  7. Sung Hoon Noh MD
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Corresponding author

Correspondence to Sung Hoon Noh MD.

Additional information

J.-H. Cheong and J. Y. Shen contributed equally to this work.

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Cheong, JH., Shen, J.Y., Song, C.S. et al. Early Postoperative Intraperitoneal Chemotherapy Following Cytoreductive Surgery in Patients with Very Advanced Gastric Cancer. Ann Surg Oncol 14, 61–68 (2007). https://doi.org/10.1245/s10434-006-9205-7

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  • DOI: https://doi.org/10.1245/s10434-006-9205-7

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