Risk Factors for Recurrence after Complete Cytoreductive Surgery and Perioperative Chemotherapy in Peritoneal Metastases from Gastric Cancer
Yutaka Yonemura1,2*, Emel Canbay1, Shouzou Sako1, Haruaki Ishibashi2, Masamitu Hirano3, Akiyoshi Mizumoto3, Kousuke Noguchi3, Nobuyuki Takao3, Masumi Ichinose3, Gorou Tsukiyama1,2, Yang Liu1 and Sachio Fushida1
- *Corresponding Author:
- Yutaka Yonemura
NPO Organization to Support Peritoneal
Surface Malignancy Treatment, Oosaka, Japan
E-mail: [email protected]
Received date: April 04, 2016; Accepted date: May 07, 2016; Published date: May 14, 2016
Citation: Yonemura Y, Canbay E, Sako S, Ishibashi H, Hirano M, et al. (2016) Risk Factors for Recurrence after Complete Cytoreductive Surgery and Perioperative Chemotherapy in Peritoneal Metastases from Gastric Cancer. J Integr Oncol 5:167. doi:10.4172/2329-6771.1000167
Copyright: © 2016 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.
Background and objective: The aim of this study is to analyze anatomical distribution, timing and outcomes of recurrence after complete cytoreduction and perioperative chemotherapy for peritoneal metastasis from gastric cancer (GCPM). Method: Data of 193 GCPM patients who underwent a complete cytoreductive surgery (CRS) after treatment with neoadjuvant chemotherapy were entered into a prospective database and the recurrence was analyzed. Result: The median time to progression was 16.2 months, median overall survival (OS) was 21.6 months and 5-year survival rate was 18.1%. Five years after CRS, 11 patients were disease free survivors. Recurrence rate was 68.5% (126/184). Mutivariate analysis confirmed small bowel peritoneal cancer index of ≥3 and pathologic nonresponders after NAC as independent risk factors for recurrence. Patients were treated with systemic chemotherapy or second cytoreductive surgery for recurrence. However, survival after diagnosis of recurrence was poor with median survival of 2.9 months. The most common type of recurrence was diffuse peritoneal recurrence (71%, 90/126). Localized intra-abdominal recurrence was experienced in only 7 patients. Conclusion: Pathologic non-responders and small bowel PCI of ≥3 are independent risk factors for recurrence. Exploratory laparoscopy after NAC might be a useful strategy for the selection of patients for CRS.