論文

国際誌
2022年1月5日

Efficacy of conversion surgery after a single intraperitoneal administration of paclitaxel and systemic chemotherapy for gastric cancer with peritoneal metastasis.

Langenbeck's archives of surgery
  • Masayuki Shinkai
  • ,
  • Motohiro Imano
  • ,
  • Yoko Hiraki
  • ,
  • Kota Momose
  • ,
  • Hiroaki Kato
  • ,
  • Osamu Shiraishi
  • ,
  • Atsushi Yasuda
  • ,
  • Masanobu Tsubaki
  • ,
  • Shozo Nishida
  • ,
  • Takushi Yasuda

407
3
開始ページ
975
終了ページ
983
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00423-021-02410-7

PURPOSE: The prognosis of gastric cancer patients with peritoneal metastasis (PM) remains dismal with standard systemic chemotherapy. Intraperitoneal (i.p.) chemotherapy with paclitaxel (PTX) has local effects on intra-abdominal cancer cells. According to this phenomenon, we have developed regimens combining single i.p. PTX administration with systemic chemotherapy. This treatment strategy is very promising; however, the effect of "conversion surgery" in patients responding to this chemotherapy is unclear. Therefore, we performed a retrospective study to evaluate the safety and efficacy of conversion surgery for gastric cancer patients with PM. METHODS: We enrolled 52 gastric cancer patients with PM who were treated with single i.p. PTX plus systemic chemotherapy between 2005 and 2015. Conversion surgery was performed where PM was eliminated by combination chemotherapy. RESULTS: Among 52 gastric cancer patients, the disappearance of PM was confirmed in 33 patients (63.5%). Gastrectomy with D2 lymph node dissection was performed in all these patients. Histological response of grade ≥ 1b was achieved in 13 patients (39%). Clavien-Dindo grade II postoperative complications occurred in three patients (9%). There were no treatment-related deaths. The median survival time and 1-, 3-, and 5-year overall survival rates of the 33 patients who underwent conversion surgery were 30.7 months and 78.8%, 36.3%, and 24.2%, respectively, and those of the 19 patients who did not undergo surgery were 12.5 months and 52.6%, 5.2%, and 0%, respectively. CONCLUSION: Conversion surgery is safe and may prolong survival for gastric cancer patients with PM who have responded to single i.p. PTX plus systemic chemotherapy.

リンク情報
DOI
https://doi.org/10.1007/s00423-021-02410-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34988644
ID情報
  • DOI : 10.1007/s00423-021-02410-7
  • PubMed ID : 34988644

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