Cytoreductive Surgery and Intraperitoneal Chemohyperthermia for Peritoneal Carcinomatosis Arising From Gastric Cancer
HYPOTHESIS The most common cause of palliative resection and recurrence in gastric cancer is peritoneal seeding. This study evaluates the efficacy of intraperitoneal chemohyperthermia after cytoreductive surgery in patients with peritoneal carcinomatosis arising from gastric cancer. DESIGN Prospecti...
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| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 2004-01, Vol.139 (1), p.20-26 |
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| creator | Glehen, O Schreiber, V Cotte, E Sayag-Beaujard, A. C Osinsky, D Freyer, G François, Y Vignal, J Gilly, F. N |
| description | HYPOTHESIS The most common cause of palliative resection and recurrence in gastric cancer is peritoneal seeding. This study evaluates the efficacy of intraperitoneal chemohyperthermia after cytoreductive surgery in patients with peritoneal carcinomatosis arising from gastric cancer. DESIGN Prospective clinical trial. SETTING Surgical department at a university academic hospital. PATIENTS Forty-nine consecutive patients with peritoneal carcinomatosis treated between January 1, 1989, and February 29, 2000. INTERVENTIONS All patients underwent intraperitoneal chemohyperthermia with mitomycin C (40-60 mg); 21 patients had previously undergone extensive cytoreductive surgery. MAIN OUTCOME MEASURES Clinicopathologic factors that affect overall survival rates. RESULTS With median follow-up of 99 months, overall median survival was 10.3 months. Two factors were significant independent predictors of survival by multivariate analysis: preoperative ascites (P = .04) and completeness of cancer resection (CCR) by cytoreductive surgery (P |
| doi_str_mv | 10.1001/archsurg.139.1.20 |
| format | Article |
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C ; Osinsky, D ; Freyer, G ; François, Y ; Vignal, J ; Gilly, F. N</creator><creatorcontrib>Glehen, O ; Schreiber, V ; Cotte, E ; Sayag-Beaujard, A. C ; Osinsky, D ; Freyer, G ; François, Y ; Vignal, J ; Gilly, F. N</creatorcontrib><description>HYPOTHESIS The most common cause of palliative resection and recurrence in gastric cancer is peritoneal seeding. This study evaluates the efficacy of intraperitoneal chemohyperthermia after cytoreductive surgery in patients with peritoneal carcinomatosis arising from gastric cancer. DESIGN Prospective clinical trial. SETTING Surgical department at a university academic hospital. PATIENTS Forty-nine consecutive patients with peritoneal carcinomatosis treated between January 1, 1989, and February 29, 2000. INTERVENTIONS All patients underwent intraperitoneal chemohyperthermia with mitomycin C (40-60 mg); 21 patients had previously undergone extensive cytoreductive surgery. MAIN OUTCOME MEASURES Clinicopathologic factors that affect overall survival rates. RESULTS With median follow-up of 99 months, overall median survival was 10.3 months. Two factors were significant independent predictors of survival by multivariate analysis: preoperative ascites (P = .04) and completeness of cancer resection (CCR) by cytoreductive surgery (P<.001). Median survival was 21.3 months for patients with CCR-0 (macroscopic complete resection) or CCR-1 (diameter of residual nodules <5 mm) and 6.1 months for patients with CCR-2 (diameter of residual nodules >5 mm) (P<.001). Four patients survived longer than 5 years. CONCLUSIONS An aggressive management strategy combining intraperitoneal chemohyperthermia with cytoreductive surgery is effective for patients with peritoneal carcinomatosis arising from gastric cancer. In highly selected patients (good general status, resectable primary tumor, resectable peritoneal carcinomatosis), this therapy may result in long-term survival.Arch Surg. 2004;139:20-26--></description><identifier>ISSN: 0004-0010</identifier><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 1538-3644</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/archsurg.139.1.20</identifier><identifier>PMID: 14718269</identifier><identifier>CODEN: ARSUAX</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Biopsy, Needle ; Cancer ; Carcinoma - mortality ; Carcinoma - secondary ; Carcinoma - therapy ; Chemotherapy ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Female ; Fever ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Hyperthermia, Induced ; Immunohistochemistry ; Male ; Medical sciences ; Middle Aged ; Mitomycin - administration & dosage ; Neoplasm Staging ; Peritoneal Neoplasms - mortality ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - therapy ; Prospective Studies ; Risk Assessment ; Stomach ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Survival Analysis ; Treatment Outcome ; Tumors</subject><ispartof>Archives of surgery (Chicago. 1960), 2004-01, Vol.139 (1), p.20-26</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright American Medical Association Jan 2004</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a3960-5a9fec1d7a233c85b170a50074eddc785d7df709e0d89e5f5ed9e770b3f80cda3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/archsurg.139.1.20$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.139.1.20$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,4024,27923,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15582724$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14718269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glehen, O</creatorcontrib><creatorcontrib>Schreiber, V</creatorcontrib><creatorcontrib>Cotte, E</creatorcontrib><creatorcontrib>Sayag-Beaujard, A. C</creatorcontrib><creatorcontrib>Osinsky, D</creatorcontrib><creatorcontrib>Freyer, G</creatorcontrib><creatorcontrib>François, Y</creatorcontrib><creatorcontrib>Vignal, J</creatorcontrib><creatorcontrib>Gilly, F. N</creatorcontrib><title>Cytoreductive Surgery and Intraperitoneal Chemohyperthermia for Peritoneal Carcinomatosis Arising From Gastric Cancer</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>Arch Surg</addtitle><description>HYPOTHESIS The most common cause of palliative resection and recurrence in gastric cancer is peritoneal seeding. This study evaluates the efficacy of intraperitoneal chemohyperthermia after cytoreductive surgery in patients with peritoneal carcinomatosis arising from gastric cancer. DESIGN Prospective clinical trial. SETTING Surgical department at a university academic hospital. PATIENTS Forty-nine consecutive patients with peritoneal carcinomatosis treated between January 1, 1989, and February 29, 2000. INTERVENTIONS All patients underwent intraperitoneal chemohyperthermia with mitomycin C (40-60 mg); 21 patients had previously undergone extensive cytoreductive surgery. MAIN OUTCOME MEASURES Clinicopathologic factors that affect overall survival rates. RESULTS With median follow-up of 99 months, overall median survival was 10.3 months. Two factors were significant independent predictors of survival by multivariate analysis: preoperative ascites (P = .04) and completeness of cancer resection (CCR) by cytoreductive surgery (P<.001). Median survival was 21.3 months for patients with CCR-0 (macroscopic complete resection) or CCR-1 (diameter of residual nodules <5 mm) and 6.1 months for patients with CCR-2 (diameter of residual nodules >5 mm) (P<.001). Four patients survived longer than 5 years. CONCLUSIONS An aggressive management strategy combining intraperitoneal chemohyperthermia with cytoreductive surgery is effective for patients with peritoneal carcinomatosis arising from gastric cancer. In highly selected patients (good general status, resectable primary tumor, resectable peritoneal carcinomatosis), this therapy may result in long-term survival.Arch Surg. 2004;139:20-26--></description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Needle</subject><subject>Cancer</subject><subject>Carcinoma - mortality</subject><subject>Carcinoma - secondary</subject><subject>Carcinoma - therapy</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Cancer, Regional Perfusion</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Fever</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hyperthermia, Induced</subject><subject>Immunohistochemistry</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitomycin - administration & dosage</subject><subject>Neoplasm Staging</subject><subject>Peritoneal Neoplasms - mortality</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - therapy</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Stomach</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. 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N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cytoreductive Surgery and Intraperitoneal Chemohyperthermia for Peritoneal Carcinomatosis Arising From Gastric Cancer</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>Arch Surg</addtitle><date>2004-01-01</date><risdate>2004</risdate><volume>139</volume><issue>1</issue><spage>20</spage><epage>26</epage><pages>20-26</pages><issn>0004-0010</issn><issn>2168-6254</issn><eissn>1538-3644</eissn><eissn>2168-6262</eissn><coden>ARSUAX</coden><abstract>HYPOTHESIS The most common cause of palliative resection and recurrence in gastric cancer is peritoneal seeding. This study evaluates the efficacy of intraperitoneal chemohyperthermia after cytoreductive surgery in patients with peritoneal carcinomatosis arising from gastric cancer. DESIGN Prospective clinical trial. SETTING Surgical department at a university academic hospital. PATIENTS Forty-nine consecutive patients with peritoneal carcinomatosis treated between January 1, 1989, and February 29, 2000. INTERVENTIONS All patients underwent intraperitoneal chemohyperthermia with mitomycin C (40-60 mg); 21 patients had previously undergone extensive cytoreductive surgery. MAIN OUTCOME MEASURES Clinicopathologic factors that affect overall survival rates. RESULTS With median follow-up of 99 months, overall median survival was 10.3 months. Two factors were significant independent predictors of survival by multivariate analysis: preoperative ascites (P = .04) and completeness of cancer resection (CCR) by cytoreductive surgery (P<.001). Median survival was 21.3 months for patients with CCR-0 (macroscopic complete resection) or CCR-1 (diameter of residual nodules <5 mm) and 6.1 months for patients with CCR-2 (diameter of residual nodules >5 mm) (P<.001). Four patients survived longer than 5 years. CONCLUSIONS An aggressive management strategy combining intraperitoneal chemohyperthermia with cytoreductive surgery is effective for patients with peritoneal carcinomatosis arising from gastric cancer. In highly selected patients (good general status, resectable primary tumor, resectable peritoneal carcinomatosis), this therapy may result in long-term survival.Arch Surg. 2004;139:20-26--></abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>14718269</pmid><doi>10.1001/archsurg.139.1.20</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Archives of surgery (Chicago. 1960), 2004-01, Vol.139 (1), p.20-26 |
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| subjects | Adult Aged Biological and medical sciences Biopsy, Needle Cancer Carcinoma - mortality Carcinoma - secondary Carcinoma - therapy Chemotherapy Chemotherapy, Cancer, Regional Perfusion Combined Modality Therapy Female Fever Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Hyperthermia, Induced Immunohistochemistry Male Medical sciences Middle Aged Mitomycin - administration & dosage Neoplasm Staging Peritoneal Neoplasms - mortality Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Prospective Studies Risk Assessment Stomach Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Survival Analysis Treatment Outcome Tumors |
| title | Cytoreductive Surgery and Intraperitoneal Chemohyperthermia for Peritoneal Carcinomatosis Arising From Gastric Cancer |
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