Abstract
Peritoneal seeding from primary gastric cancer occurs in 10–20% of patients. The diagnosis of this advanced disease is usually confirmed by laparoscopy prior to a major surgical exploration. From the data available in the literature, the surgeon is forced to make a judgment concerning the risks and benefits of an aggressive management plan versus supportive care. A strategy has evolved that utilizes induction intravenous and intraperitoneal chemotherapy followed by peritonectomy and extended gastrectomy to maximally treat the primary tumor and the peritoneal seeding. In the current state of the art, the induction chemotherapy is given prior to a clinical evaluation to select patients for a major cancer resection. The pharmacologic parameters have been established and the results of phase II studies are reported. Three-year survival of 45 patients who had a complete cytoreduction was 19% with a median survival of 20.4 months. Gastrectomy with peritonectomy to eliminate all visible evidence of disease after a response to induction bidirectional chemotherapy should be considered in patients with primary gastric cancer and carcinomatosis.
Keywords
- Gastric Cancer
- Peritoneal Carcinomatosis
- Intraperitoneal Chemotherapy
- Primary Gastric Cancer
- Complete Cytoreduction
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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© 2011 Springer-Verlag Berlin Heidelberg
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Yonemura, Y., Sugarbaker, P.H. (2011). Induction Bidirectional Chemotherapy for Gastric Cancer with Peritoneal Dissemination. In: Aigner, K., Stephens, F. (eds) Induction Chemotherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18173-3_11
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DOI: https://doi.org/10.1007/978-3-642-18173-3_11
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