Indications for Early Postoperative Intraperitoneal Chemotherapy of Advanced Gastric Cancer: Results of a Prospective Randomized Trial
Previous analysis of this prospective randomized trial and meta‐analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sough...
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| Veröffentlicht in: | World journal of surgery 2001-08, Vol.25 (8), p.985-990 |
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| creator | Yu, Wansik Whang, Ilwoo Chung, Ho Young Averbach, Andrew Sugarbaker, Paul H. |
| description | Previous analysis of this prospective randomized trial and meta‐analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis. From 1990 to 1995 a series of 248 patients with biopsy‐proven gastric cancer were randomized intraoperatively to receive early postoperative intraperitoneal mitomycin C and 5‐fluorouracil (125 patients) versus surgery only (123 patients). Gastric resection plus early postoperative intraperitoneal chemotherapy showed improved overall survival compared to surgery only (54% and 38%, respectively; p= 0.0278). There were statistically significant differences in patients with stage III (57% and 23%, respectively; p= 0.0024) and in those with stage IV (28% and 5%, respectively; p= 0.0098) gastric cancer. The improvement in survival rate was statistically significant for the subgroup of patients with gross serosal invasion (52% and 25%, respectively; p= 0.0004) and patients with lymph node metastasis (46% and 22%, respectively; p= 0.0027). The surgeons' impression about lymph node status was unreliable, but assessment of serosal invasion was accurate in 80% of cases. Gross serosal invasion with or without frozen section evaluation of lymph nodes can be used as the major selection criteria for early postoperative intraperitoneal chemotherapy of advanced gastric cancer. |
| doi_str_mv | 10.1007/s00268-001-0067-7 |
| format | Article |
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Simple criteria applicable at the time of surgery for patient selection were sought in this analysis. From 1990 to 1995 a series of 248 patients with biopsy‐proven gastric cancer were randomized intraoperatively to receive early postoperative intraperitoneal mitomycin C and 5‐fluorouracil (125 patients) versus surgery only (123 patients). Gastric resection plus early postoperative intraperitoneal chemotherapy showed improved overall survival compared to surgery only (54% and 38%, respectively; p= 0.0278). There were statistically significant differences in patients with stage III (57% and 23%, respectively; p= 0.0024) and in those with stage IV (28% and 5%, respectively; p= 0.0098) gastric cancer. The improvement in survival rate was statistically significant for the subgroup of patients with gross serosal invasion (52% and 25%, respectively; p= 0.0004) and patients with lymph node metastasis (46% and 22%, respectively; p= 0.0027). The surgeons' impression about lymph node status was unreliable, but assessment of serosal invasion was accurate in 80% of cases. Gross serosal invasion with or without frozen section evaluation of lymph nodes can be used as the major selection criteria for early postoperative intraperitoneal chemotherapy of advanced gastric cancer.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-001-0067-7</identifier><identifier>PMID: 11571980</identifier><identifier>CODEN: WJSUDI</identifier><language>eng</language><publisher>New York: Springer‐Verlag</publisher><subject>Antibiotics, Antineoplastic - administration & dosage ; Antineoplastic agents ; Biological and medical sciences ; Combined Modality Therapy ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; Female ; Humans ; Infusions, Parenteral ; Male ; Medical sciences ; Middle Aged ; Mitomycin - administration & dosage ; Neoplasm Staging ; Pharmacology. Drug treatments ; Postoperative Care ; Postoperative Complications - epidemiology ; Prospective Studies ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Survival Rate ; Time Factors ; Tropical medicine</subject><ispartof>World journal of surgery, 2001-08, Vol.25 (8), p.985-990</ispartof><rights>2001 International Society of Surgery</rights><rights>2001 INIST-CNRS</rights><rights>by Société Internationale de Chirurgie 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4107-7b1007c53a680670f57a995ba7436a6a9d1defbc35b71173185b129168016e5f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1007%2Fs00268-001-0067-7$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1007%2Fs00268-001-0067-7$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1120027$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11571980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Wansik</creatorcontrib><creatorcontrib>Whang, Ilwoo</creatorcontrib><creatorcontrib>Chung, Ho Young</creatorcontrib><creatorcontrib>Averbach, Andrew</creatorcontrib><creatorcontrib>Sugarbaker, Paul H.</creatorcontrib><title>Indications for Early Postoperative Intraperitoneal Chemotherapy of Advanced Gastric Cancer: Results of a Prospective Randomized Trial</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><description>Previous analysis of this prospective randomized trial and meta‐analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis. From 1990 to 1995 a series of 248 patients with biopsy‐proven gastric cancer were randomized intraoperatively to receive early postoperative intraperitoneal mitomycin C and 5‐fluorouracil (125 patients) versus surgery only (123 patients). Gastric resection plus early postoperative intraperitoneal chemotherapy showed improved overall survival compared to surgery only (54% and 38%, respectively; p= 0.0278). There were statistically significant differences in patients with stage III (57% and 23%, respectively; p= 0.0024) and in those with stage IV (28% and 5%, respectively; p= 0.0098) gastric cancer. The improvement in survival rate was statistically significant for the subgroup of patients with gross serosal invasion (52% and 25%, respectively; p= 0.0004) and patients with lymph node metastasis (46% and 22%, respectively; p= 0.0027). 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Drug treatments</topic><topic>Postoperative Care</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Tropical medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Wansik</creatorcontrib><creatorcontrib>Whang, Ilwoo</creatorcontrib><creatorcontrib>Chung, Ho Young</creatorcontrib><creatorcontrib>Averbach, Andrew</creatorcontrib><creatorcontrib>Sugarbaker, Paul H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Wansik</au><au>Whang, Ilwoo</au><au>Chung, Ho Young</au><au>Averbach, Andrew</au><au>Sugarbaker, Paul H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Indications for Early Postoperative Intraperitoneal Chemotherapy of Advanced Gastric Cancer: Results of a Prospective Randomized Trial</atitle><jtitle>World journal of surgery</jtitle><addtitle>World J Surg</addtitle><date>2001-08</date><risdate>2001</risdate><volume>25</volume><issue>8</issue><spage>985</spage><epage>990</epage><pages>985-990</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><coden>WJSUDI</coden><abstract>Previous analysis of this prospective randomized trial and meta‐analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis. From 1990 to 1995 a series of 248 patients with biopsy‐proven gastric cancer were randomized intraoperatively to receive early postoperative intraperitoneal mitomycin C and 5‐fluorouracil (125 patients) versus surgery only (123 patients). Gastric resection plus early postoperative intraperitoneal chemotherapy showed improved overall survival compared to surgery only (54% and 38%, respectively; p= 0.0278). There were statistically significant differences in patients with stage III (57% and 23%, respectively; p= 0.0024) and in those with stage IV (28% and 5%, respectively; p= 0.0098) gastric cancer. The improvement in survival rate was statistically significant for the subgroup of patients with gross serosal invasion (52% and 25%, respectively; p= 0.0004) and patients with lymph node metastasis (46% and 22%, respectively; p= 0.0027). The surgeons' impression about lymph node status was unreliable, but assessment of serosal invasion was accurate in 80% of cases. Gross serosal invasion with or without frozen section evaluation of lymph nodes can be used as the major selection criteria for early postoperative intraperitoneal chemotherapy of advanced gastric cancer.</abstract><cop>New York</cop><pub>Springer‐Verlag</pub><pmid>11571980</pmid><doi>10.1007/s00268-001-0067-7</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0364-2313 |
| ispartof | World journal of surgery, 2001-08, Vol.25 (8), p.985-990 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Antibiotics, Antineoplastic - administration & dosage Antineoplastic agents Biological and medical sciences Combined Modality Therapy Combined treatments (chemotherapy of immunotherapy associated with an other treatment) Female Humans Infusions, Parenteral Male Medical sciences Middle Aged Mitomycin - administration & dosage Neoplasm Staging Pharmacology. Drug treatments Postoperative Care Postoperative Complications - epidemiology Prospective Studies Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Survival Rate Time Factors Tropical medicine |
| title | Indications for Early Postoperative Intraperitoneal Chemotherapy of Advanced Gastric Cancer: Results of a Prospective Randomized Trial |
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