Peritoneal carcinomatosis in gastric cancer is associated with a dismal prognosis.Systemic chemotherapy is not effective because of the existence of a blood-peritoneal barrier.Cytoreductive surgery and intraperitoneal...Peritoneal carcinomatosis in gastric cancer is associated with a dismal prognosis.Systemic chemotherapy is not effective because of the existence of a blood-peritoneal barrier.Cytoreductive surgery and intraperitoneal chemotherapy can improve survival and quality of life in selected patients.Patient selection for this multimodal approach is one of the most critical issues,and calls for interdisciplinary evaluation by radiologists,medical and surgical oncologists,and anaesthetists.This article sets forth criteria for selection of gastric cancer patients suffering from peritoneal carcinomatosis.展开更多
AIM:To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS:Of 150 patients 100 were treated with cytoreductiv...AIM:To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS:Of 150 patients 100 were treated with cytoreductive surgery and HIPEC and retrospectively analyzed.Clinical and postoperative follow-up data were evaluated.Body mass index(BMI),age and peritoneal carcinomatosis index(PCI) were chosen as selection criteria with regard to tumor-free survival and perioperative morbidity for this multimodal therapy.RESULTS:CRS with HIPEC was successfully performed in 100 out of 150 patients.Fifty patients were excluded because of intraoperative contraindication.Median PCI was 17(1-39).In 89% a radical resection(CC0/CC1) was achieved.One patient died postoperatively due to multiorgan failure.Neither PCI,age nor BMI was a risk factor for postoperative complications/outcome according to the DINDO classification.In 9% Re-CRS with HIPEC was performed during the follow-up period.CONCLUSION:Patient selection remains the most important issue.Neither PCI,age nor BMI alone should be an exclusion criterion for this multimodal therapy.展开更多
文摘Peritoneal carcinomatosis in gastric cancer is associated with a dismal prognosis.Systemic chemotherapy is not effective because of the existence of a blood-peritoneal barrier.Cytoreductive surgery and intraperitoneal chemotherapy can improve survival and quality of life in selected patients.Patient selection for this multimodal approach is one of the most critical issues,and calls for interdisciplinary evaluation by radiologists,medical and surgical oncologists,and anaesthetists.This article sets forth criteria for selection of gastric cancer patients suffering from peritoneal carcinomatosis.
文摘AIM:To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS:Of 150 patients 100 were treated with cytoreductive surgery and HIPEC and retrospectively analyzed.Clinical and postoperative follow-up data were evaluated.Body mass index(BMI),age and peritoneal carcinomatosis index(PCI) were chosen as selection criteria with regard to tumor-free survival and perioperative morbidity for this multimodal therapy.RESULTS:CRS with HIPEC was successfully performed in 100 out of 150 patients.Fifty patients were excluded because of intraoperative contraindication.Median PCI was 17(1-39).In 89% a radical resection(CC0/CC1) was achieved.One patient died postoperatively due to multiorgan failure.Neither PCI,age nor BMI was a risk factor for postoperative complications/outcome according to the DINDO classification.In 9% Re-CRS with HIPEC was performed during the follow-up period.CONCLUSION:Patient selection remains the most important issue.Neither PCI,age nor BMI alone should be an exclusion criterion for this multimodal therapy.
