Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter Gastric Cancer Research group’s analysis

World Journal of Surgical Oncology

Michela Caprioli¹  Silvia Ministrini¹  Guido Alberto Massimo Tiberio¹  Maurizio Degiuli²  Gianni Mura³  Paolo Morgagni⁴  Leonardo Solaini⁴  Alessia D’Ignazio⁵  Daniele Marrelli⁵  Franco Roviello⁵  Annibale Donini⁶  Luigina Graziosi⁶  Elisabetta Marino⁶  Michele Sacco⁷  Maria Bencivenga⁷  Giovanni De Manzoni⁷ 

[1]Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy

[2]Department of Oncology, Head, Digestive and Surgical Oncology, University of Torino, and San Luigi University Hospital, Orbassano, Italy

[3]Department of Surgery, Azienda USl Toscana SudEst—Arezzo, Arezzo, Italy

[4]Department of Surgery, General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Via Forlanini 34, Forlì, Italy

[5]Department of Surgery, Policlinico le Scotte, University of Siena, Siena, Italy

[6]General and Emergency Surgery, Santa Maria della Misericordia Hospital University of Perugia, Perugia, Italy

[7]General and Upper GI Surgery Division, University of Verona, Verona, Italy

关键词: Gastric cancer;    Peritoneal carcinomatosis;    Surgery;   

DOI  :  10.1186/s12957-021-02442-9

来源: Springer

【 摘 要 】

BackgroundThe present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery.MethodsIt is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences.ResultsOur results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could benefit from an aggressive surgical approach performing an extended lymphadenectomy and HIPEC treatment.ConclusionThe main result of the study is that GC patients with limited peritoneal involvement can have a survival benefit from a surgery with “radical oncological intent”, that means extended lymphadenectomy and R0 resection. The retrospective nature of this study is an important bias, and for this reason, we have started a prospective multicentric study including Italian stage IV patients that hopefully will give us more answers.

【 授权许可】

CC BY