Impact of maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin: Results of the GYMSSA trial
作者： Udo Rudloff , Russell C. Langan , John E. Mullinax , Joal D. Beane , Seth M. Steinberg
DOI: 10.1002/JSO.23633
关键词:
摘要: Background: A prospective randomized trial was conducted to compare the impact of systemic chemotherapy versus multi‐modality therapy (complete cytoreductive surgery (CRS), hyperthermic intraperitoneal (HIPEC), and chemotherapy) on overall survival (OS) in patients with gastric carcinomatosis. Methods: Patients measurable metastatic adenocarcinoma involving peritoneum, resectable “no evidence disease” were gastrectomy, metastasectomy, HIPEC, FOLFOXIRI (GYMS arm) or alone (SA arm). Results:Seventeenpatientswereenrolled(16evaluable);7of9patientsinthemulti‐modalityGYMSarmachievedcompletecytoreduction(CCR0). MedianOS was11.3monthsinthe GYMSarmand 4.3monthsintheSA arm.Fourpatientsin theGYMSarm survived>12months,2patients close 2 years at last follow‐up, 1 patient more than 4 years, these still alive. No SA arm lived beyond 11 months. All surviving 12 months achieved complete cytoreduction had an initial Peritoneal Cancer Index (PCI) � 15. Conclusion: Maximal combined regional (HIPEC) selected carcinomatosis limited disease burden can achieve prolonged survival. J. Surg. Oncol. 2014;110:275–284. 2014 Wiley Periodicals, Inc.
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