Japanese practice of comprehensive treatment for peritoneal metastasis of gastric cancer

Abstract

Patients with peritoneal metastasis (PM) from gastric cancer (GC) have a poor prognosis. Surgery or systemic treatment alone hardly improves the prognosis and overall survival (OS). A newly developed comprehensive treatment involving a combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used to treat patients with PM from GC. The Peritoneal Dissemination Center of Kishiwada Tokushukai Hospital in Japan has been committed to treating patients with PM from GC. Selected patients undergo laparoscopic hyperthermic intraperitoneal chemotherapy (LHIPEC), preoperative intraperitoneal (IP) chemotherapy, and systemic chemotherapy that includes intravenous and oral chemotherapy prior to surgery. CRS plus HIPEC is then performed to achieve complete cytoreduction. Postoperative IP chemotherapy or systemic chemotherapy is also administered to nearly all patients. The results demonstrate that comprehensive treatment, including neoadjuvant chemotherapy and CRS plus HIPEC, can significantly improve the prognosis and OS of selected patients with PM from GC.