Early postoperative intraperitoneal chemotherapy following cytoreductive surgery in patients with very advanced gastric cancer

Jae Ho Cheong, Jia Yun Shen, Chang Soo Song, Woo Jin Hyung, Jian Guo Shen, Seung Ho Choi, Sung Hoon Noh

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33 Citations (Scopus)


Background: The survival of patients with stage IV gastric cancer is poor due to frequent peritoneal failure. The aim of this study was to investigate the impact of early postoperative intraperitoneal chemotherapy (EPIC) after cytoreductive surgery on the long-term survival of these patients, as determined by residual disease status. Methods: A total of 154 patients with stage IV gastric cancer were enrolled in our study. All patients underwent potentially curative or palliative resections. After surgery, the residual disease states of the patients were recorded. All patients received EPIC. Results: Of all 154 patients, R0 resection was achieved in 37, R1 in 56, and R2 in 61. All patients received a mean of 4.3 EPIC perfusions. After a mean followup period of 29 months, 14 patients remained alive. The median survival of all 154 patients was 11.4 months. Survival times were analyzed according to the type of residual tumor; the median survival time was 25.5 months in the R0 group, 15.6 months in the R1 group, and 7.2 months in the R2 group (p < .001). Upon multivariate analysis, the residual tumor states and the cycle of EPIC perfusion were found to be independent prognostic predictors (p < .001 and p = .018, respectively). Conclusions: The residual tumor status is the most important predictor for the survival of very advanced gastric cancer patients who received cytoreductive surgery and EPIC. Therefore, complete cytoreductive surgery yielding R0 resection is mandatory for achieving the beneficial effects of EPIC.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalAnnals of surgical oncology
Issue number1
Publication statusPublished - 2007 Jan

Bibliographical note

Funding Information:
This work was supported by the Korea Science and Engineering Foundation (KOSEF) through the Cancer Metastasis Research Center (CMRC) at Yonsei University College of Medicine.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology


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