Phase II study of patients with peritoneal carcinomatosis from gastric cancer treated with preoperative systemic chemotherapy followed by peritonectomy and intraperitoneal chemotherapy

Figures & data

Table I. Demographic data, basic clinical data and treatment data of 18 patients with peritoneal carcinomatosis from gastric adenocarcinoma enrolled for loco-regional treatment.

Variables	Number of patients
Median age 57 years (38–74)
Gender
Female	8
Male	10
Karnofsky performance status
90–100	14
70	2
MD	2
Tumor grade status
T3	11
T4	1
MD	6
Lymph node status
N0	2
N1	3
N2	3
N3	1
MD	9
Signet ring cells
Yes	13
No	5
Neoadjuvant chemotherapy
Irinotecan + Nordic FLv	6
EOX	6
FLOX	3
Docetaxel + Irinotecan + 5-FU + LV	1
FOLFIRI	1
ECF	1
Cytoreductive surgery
Yes	8
No	8
Open and shut	2
Peritoneal Cancer Index for cytoreductive surgery patients
< 9	3
9–12	1
13–18	2
>18	2
Completeness of cytoreduction scores for cytoreductive surgery patients
CC0	6
CC1	1
CC2	1

CC0, no peritoneal seeding visible; CC1, nodules up to 2.5 mm; CC2, nodules up to 2.5 cm; ECF, epirubicin + cisplatin +  5-fluorouracil; EOX, epirubicin + oxaliplatin + capecitabine; 5-FU, 5-fluorouracil; FLOX, 5-fluorouracil + leucovorin + oxaliplatin; FOLFIRI, leucovorin + 5-fluorouracil + irinotecan; LV, leucovorin; MD, missing data; Nordic FLv, bolus 5-fluorouracil + leucovorin.

Table II. Adverse events (AEs) of grades II–IV in relation to neoadjuvant period; cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) + early intraperitoneal chemotherapy (EPIC) period; and late period (postoperative in-hospital until death).

	Neoadjuvant	CRS/HIPEC/ EPIC	Late period
Thromboembolism		2	1
Intracranial haemorrhage			2
Anastomotic leakage		3
Bowel perforation		1	1
Intra-abdominal abscess	1	1	1
Septicemia	1
GI-function disturbance	19	2	6
Psychiatric/psychological	3	1	3
Neurological	11		5
Hematogenic	2	1	1
Dermatological			2
Variety of symptoms	10	2	7

GI-function disturbance, AEs related to gastrointestinal function such as diarrhea, nausea, vomiting, obstipation and dysphagia; Psychiatric/psychological, depression, anxiety, insomnia.

Table III. Data from trials on CRS + HIPEC in patients with PC from GC.

Author	Publication year	No of patients	Chemo EPIC	Mortality (%)	Morbidity (%)	OS (months)	1-year survival (%)	2-year survival (%)	3-year survival (%)
Rossi [40]	2003	13	No	0	26	15	MD	MD	MD
Glehen [4]	2004	49	No	4	27	10.3	39	14	10
Hall [5]	2004	34	No	0	35	8.0	36	26	23
Yonemura [6]	2005	42	No	7	43	11.5	31	14	MD
Farma [9]	2005	9	Yes	11	67	9.0	22	11	11
Gusani [41]	2007	2	No	MD	MD	MD	MD	MD	MD
Spiliotis [42]	2008	3	No	MD	MD	10	33	0	0
Yang [28]	2009	12	No	MD	MD	29	> 75	MD	MD
Yang [8]	2010	28	No	0	14.3	9.2	28	14	7
Glehen [7]	2010	150	Yes/No	6.5	27.8	9.2	43	23	18
Yang [10]	2011	34	No	0	14.7	11.0	42	15	6
Present study	-	8	Yes	0	62.5	14.3	62.5	37.5	0

EPIC, early postoperative intraperitoneal chemotherapy; MD, missing data; OS, overall survival.

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