Effect of Hyperthermic Intraperitoneal Chemotherapy on Long Term Survival in Gastric Cancer with Peritoneal Metastasis Treated With Preoperative Intraperttoneal Chemotherapy plus Peritonectomy: The Phase III PM-GC-1 Trial

Yutaka Yonemura*; Haruaki Ishibashi; Takuji Fujita; Yang Liu; Satoshi Wakama; Syouzou Sako; Toshiyuki Kitai; Yasuo Hirono; Shouzou Sako; Akiyoshi Mizumoto; Sachio Fushida; Nobuyuki Takao; Keizou Taniguchi; Daisuke Fujimoto

Yutaka Yonemura*, Haruaki Ishibashi, Takuji Fujita, Yang Liu, Satoshi Wakama, Syouzou Sako, Toshiyuki Kitai, Yasuo Hirono, Shouzou Sako, Akiyoshi Mizumoto, Sachio Fushida, Nobuyuki Takao, Keizou Taniguchi and Daisuke Fujimoto

Volume5-Issue7
Dates: Received: 2024-06-13 | Accepted: 2024-07-03 | Published: 2024-07-08
Pages: 710-717

Abstract

The presentation aims to describe the theory for Comprehensive Treatment (COMPT) in order to achieve cure of Colorectal Cancer (CRC)-patients with Peritoneal Metastasis (PM). Comprehensive Treatment (COMPT) consists of complete resection of macroscopic PM and eradication of residual MicroM metastasis (MM) by Intraoperative Hyperthermic Intraperitoneal Chemoperfuion (IOHIPEC). There are four scenarios for cure following COMPT. Scenario A involves cases without MM, where patients will be cured by Cytoreductive Surgery (CRS) alone. Similarly, if the residual number of MM is below than the threshold level that can be completely eliminated by IOHIPEC, patients will be cured (Scenario C). If NAC reduces the MM burden below the threshold level, patients may then be cured by CRS combined with IOHIPEC (Scenario D). If NAC completely eliminates MM, patients will then be cured by CRS alone (Scenario F). Cure is defined as patients survive without recurrence longer than five years after COMPT. The number of cured patients cured were 27/304 (8.9%). Among 304 CRC-patients with PM, ten patients were treated with CRS alone, and one patient with PCI of 4 was cured (Scenario A). Seventy-three patients were treated with CRS plus neoadjuvant chemotherapy (NAC), and 4 (5.5%) were cured (Scenario F).Fifteen patients were treated with CRS plus IOHIPEC, and 3 (20.0%) were cured (Scenario C) 206 patients were treated with NAC plus CRS plus IOHIPEC, and 19 (9.2%) patients were cured (Scenario D). When the patients with PCI less than 4, these patients have a chance of cure by complete removal of PM (CCR-0). CRC-patients with PCI ≤ 12 can be cured by NAC plus CCR-0 CRS plus IOHIPEC. When the patients treated using NAC are considered able to undergo complete, CRS, CRS and intraoperative HIPEC are recommended.

FullText HTML FullText PDF DOI: 10.37871/jbres1946

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Yonemura Y, Ishibashi H, Fujita T, Liu Y, Wakama S, Sako S, Kitai T, Hirono Y, Sako S, Mizumoto A, Fushida S, Takao N, Taniguchi K, Fujimoto D. Effect of Hyperthermic Intraperitoneal Chemotherapy on Long Term Survival in Gastric Cancer with Peritoneal Metastasis Treated With Preoperative Intraperttoneal Chemotherapy plus Peritonectomy: The Phase III PM-GC-1 Trial. J Biomed Res Environ Sci. 2024 Jul 08; 5(7): 710-717. doi: 10.37871/jbres1946, Article ID: JBRES1946, Available at: https://www.jelsciences.com/ articles/jbres1946.pdf

Subject area(s)

Clinical Trials

Cancer

Gastroenterology

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