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Systemic chemotherapy for peritoneal disseminated gastric cancer with inadequate oral intake: a retrospective study

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Abstract

Background

Oral fluoropyrimidines are widely used as standard treatment for gastric cancer, but peritoneal disseminated gastric cancer patients are often ineligible for chemotherapy using oral anticancer agents because of inadequate oral intake. The purpose of this study was to evaluate the treatment outcome and identify the prognostic factors in gastric cancer patients with inadequate oral intake resulting from peritoneal dissemination.

Methods

Seventy-nine patients with peritoneal disseminated gastric cancer receiving systemic chemotherapy as the first-line treatment option at our hospital between April 1999 and December 2006, and who were administered intravenous drip infusion because of inadequate oral intake, were retrospectively analyzed.

Results

All patients received 5-fluorouracil (5-FU)-based chemotherapy. Of the 79 treated patients, 71 had ascites as peritoneal dissemination and the remaining 8 had only gastrointestinal stenosis without ascites. Eleven (15%) patients showed an improvement in ascites. Proportion of oral intake improvement was 33%. Median time to progression and overall survival time was 1.7 months [95% confidence interval (CI), 0.9–2.4 months] and 3.3 months (95% CI, 2.1–4.5 months), respectively. Four independent poor prognostic factors were identified in multivariate analysis: serum albumin < 3.0 g/dl [hazard ratio (HR) 1.69, P = 0.03], performance status ≥ 3 (HR 1.78, P = 0.05), massive ascites (HR 1.79, P = 0.04), and serum C-reactive protein ≥ 2.0 mg/dl (HR 2.03, P < 0.01).

Conclusion

The efficacy of 5-FU-based chemotherapy for peritoneal disseminated gastric cancer patients with inadequate oral intake was unsatisfactory.

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References

  1. Parkin DM, Bray F, Ferlay J et al (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  2. Dupont JB Jr, Lee JR, Burton GR et al (1987) Adenocarcinoma of the stomach: review of 1497 cases. Cancer (Phila) 41:941–947

    Article  Google Scholar 

  3. D’Angelica M, Gonen M, Brennan MF et al (2004) Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg 240:808–816

    Article  PubMed  Google Scholar 

  4. Yoo CH, Noh SH, Shin DW et al (2000) Recurrence following curative resection for gastric carcinoma. Br J Surg 87:236–242

    Article  CAS  PubMed  Google Scholar 

  5. Boku N, Yamamoto S, Fukuda H et al (2009) Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol 10:1063–1069

    Article  CAS  PubMed  Google Scholar 

  6. Cunningham D, Starling N, Rao S et al (2008) Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 358:36–46

    Article  CAS  PubMed  Google Scholar 

  7. Kang YK, Kang WK, Shin DB et al (2009) Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomized phase III noninferiority trial. Ann Oncol 20:666–673

    Article  PubMed  Google Scholar 

  8. Lee J, Lim T, Uhm JE et al (2007) Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma. Ann Oncol 18:886–891

    Article  CAS  PubMed  Google Scholar 

  9. Elahi MM, McMillan DC, McArdle CS et al (2004) Score based on hypoalbuminemia and elevated C-reactive protein predicts survival in patients with advanced gastrointestinal cancer. Nutr Cancer 48:171–173

    Article  CAS  PubMed  Google Scholar 

  10. Al-Batran SE, Hartmann JT, Probst S et al (2008) Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol 26:1435–1442

    Article  CAS  PubMed  Google Scholar 

  11. Van Cutsem E, Moiseyenko VM, Tjulandin S et al (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol 24:4991–4997

    Article  PubMed  Google Scholar 

  12. Emi Y, Yamamoto M, Takahashi I et al (2008) Phase II study of weekly paclitaxel by one-hour infusion for advanced gastric cancer. Surg Today 38:1013–1020

    Article  CAS  PubMed  Google Scholar 

  13. Yamada Y, Shirao K, Ohtsu A et al (2001) Phase II trial of paclitaxel by three-hour infusion for advanced gastric cancer with short premedication for prophylaxis against paclitaxel-associated hypersensitivity reactions. Ann Oncol 12:1133–1137

    Article  CAS  PubMed  Google Scholar 

  14. Kobayashi M, Sakamoto J, Namikawa T et al (2006) Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients. World J Gastroenterol 12:1412–1415

    CAS  PubMed  Google Scholar 

  15. Oh SY, Kwon HC, Lee S et al (2007) A Phase II study of oxaliplatin with low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) for gastric cancer patients with malignant ascites. Jpn J Clin Oncol 37:930–935

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Makiko Shinogi for her invaluable assistance in the preparation of this manuscript. We received no financial support.

Conflict of interest

We have no conflicts of interest to declare.

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Authors and Affiliations

  1. Gastrointestinal Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Satoru Iwasa, Takako Eguchi Nakajima, Ken Kato, Tetsuya Hamaguchi, Yasuhide Yamada & Yasuhiro Shimada

  2. Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center Hospital, Tokyo, Japan

    Kenichi Nakamura & Atsuo Takashima

Authors
  1. Satoru Iwasa
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  2. Takako Eguchi Nakajima
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  3. Kenichi Nakamura
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  4. Atsuo Takashima
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  5. Ken Kato
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  6. Tetsuya Hamaguchi
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  7. Yasuhide Yamada
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  8. Yasuhiro Shimada
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Corresponding author

Correspondence to Takako Eguchi Nakajima.

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Iwasa, S., Nakajima, T.E., Nakamura, K. et al. Systemic chemotherapy for peritoneal disseminated gastric cancer with inadequate oral intake: a retrospective study. Int J Clin Oncol 16, 57–62 (2011). https://doi.org/10.1007/s10147-010-0135-9

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  • DOI: https://doi.org/10.1007/s10147-010-0135-9

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