Management of Peritoneal Metastases Developed from Gastric Cancer: Laparascopic Hyperthermic Intraperitoneal Chemontherapy in Neoadjuvant SettingYutaka Yonemura1*, Emel Canbay1, Shouzou Sako1, Haruaki Ishibashi2, Masamitu Hirano3, Akiyoshi Mizumoto3, Kazuyosi Takeshita1, Kousuke Noguchi3, Nobuyuki Takao3, Masumi Ichinose3, Yang Liu4 and Yan Li4
- *Corresponding Author:
- Yutaka Yonemura
Department of Regional Cancer Therapies
NPO to Support Peritoneal Disseminated Diseases
Kishiwada Tokushukai Hospital, 1-26
Haruki-Moto-Machi, Kishiwada City, Osaka, Japan
E-mail: [email protected]
Received date April 24, 2014; Accepted date May 29, 2014; Published date June 06, 2014
Citation: Yonemura Y, Emel Canbay, Shouzou Sako, Haruaki Ishibashi, Masamitu Hirano Akiyoshi Mizumoto, Kazuyosi Takeshita, Kousuke Noguchi, Nobuyuki Takao, Masumi Ichinose, Yang Liu and Yan Li (2014) Management of Peritoneal Metastases Developed from Gastric Cancer: Laparascopic Hyperthermic Intraperitoneal Chemontherapy in Neoadjuvant Setting. J Integr Oncol 3:117. doi:10.4172/2329-6771.1000117
Copyright: © 2014 Yonemura Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Peritoneal Metastases (PM) of Gastric Cancer (GC) are lesions of peritoneal surfaces, which may cause the dissemination throughout the abdominal cavity. The role of laparoscopic Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as neoadjuvant purpose in the management of PM of GC is undefined.
Methods: Fifty patients were enrolled into this study with histopathological diagnosis of PM of GC referred to our center between 2012 and 2013 All patients were underwent two cycles of neoadjuvant laparoscopic HIPEC. At the second session of LHIPEC, ascites volume, cytological status and PCI levels were compared with those at the 1st LHIPEC.
Results: There was no intraoperative complication and mortality after LHIPEC. Four patients developed mild azotemia of Grade 2. Amount of ascites were completely abolished or decreased in 22 of 34 (64.7%) and positive peritoneal cytology changed to be a negative in 14 of 20 (70%) patients at the 2nd LHIPEC. Complete response was in 6 (12%), and peritoneal cancer indices (PCI) were significantly reduced from 14.3 ± 10.2 at the 1st LHIPEC to 10.8 ± 10.5 at the 2nd LHIPEC (p<0.05). Furthermore, total PCI scores on small bowel mesentery at 1st and 2nd LHIPEC were 6.56 ± 2.92 and 5.25 ± 3.78 (P=0.016).
Conclusions: This study identified two outcomes. Diagnostic and therapeutic laparoscopy can be performed safely in patients with PM of GC. Laparoscopic HIPEC can be applied as a neoadjuvant treatment modality in order to reduce the tumor burden and disease control until complete managements to be achieved in patients with PM of GC.