Cytoreductive surgery and hyperthermic intraperitonealchemotherapy in gastric cancer

作     者：Ramakrishnan Ayloor Seshadri Olivier Glehen 

作者机构：Department of Surgical OncologyCancer Institute(WIA)Chennai 600036India Service de Chirurgie Viscérale et EndocrinienneHospices Civils de LyonCentre Hospitalier Lyon-Sud69495 Pierre-Bénite CedexFrance UniversitéLyon 1EMR 373869921 OullinsFrance 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2016年第22卷第3期

页      面：1114-1130页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gastric cancer Peritoneal carcinomatosis Cytoreductive surgery Hyperthermic intraperitonealchemotherapy 

摘      要：Gastric cancer associated peritoneal carcinomatosis(GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase the survival in GCPC. Since recurrent gastric cancer remains confined to the abdominal cavity in many patients, regional therapies like aggressive cytoreductive surgery( CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) have been investigated for GCPC. HIPEC has been used for three indications in GC- as an adjuvant therapy after a curative surgery, HIPEC has been shown to improve survival and reduce peritoneal recurrences in many randomised trials in Asian countries; as a definitive treatment in established PC, HIPEC along with CRS is the only therapeutic modality that has resulted in longterm survival in select groups of patients; as a palliative treatment in advanced PC with intractable ascites, HIPEC has been shown to control ascites and reduce the need for frequent paracentesis. While the results of randomised trials of adjuvant HIPEC from western centres are awaited, the role of HIPEC in the treatment of GCPC is still evolving and needs larger studies before it is accepted as a standard of care.