Please use this identifier to cite or link to this item:
|Title:||Conversion Surgery Post-Intraperitoneal Paclitaxel and Systemic Chemotherapy for Gastric Cancer Carcinomatosis Peritonei. Are We Ready?||Authors:||Chan D.Y.S.
|Issue Date:||1-Mar-2017||Publisher:||Springer New York LLC||Citation:||Chan D.Y.S., Syn N.L.-X., Yap R., Phua J.N.S., Soh T.I.P., Chee C.E., Nga M.E., Shabbir A., So J.B.Y., Yong W.P. (2017-03-01). Conversion Surgery Post-Intraperitoneal Paclitaxel and Systemic Chemotherapy for Gastric Cancer Carcinomatosis Peritonei. Are We Ready?. Journal of Gastrointestinal Surgery 21 (3) : 425-433. ScholarBank@NUS Repository. https://doi.org/10.1007/s11605-016-3336-3||Abstract:||Peritoneal metastasis is common in gastric cancer. It is difficult to treat and carries a poor prognosis. Intraperitoneal (IP) delivery of chemotherapy can attain a higher drug exposure in the peritoneal cavity but with reduced systemic toxicity. Therefore, we hypothesized that IP paclitaxel with systemic chemotherapy would be clinically beneficial for gastric cancer with peritoneal metastases. Patients with unresectable and/or recurrent gastric adenocarcinoma with peritoneal dissemination and/or positive peritoneal washing cytology were recruited. They underwent eight cycles of IP paclitaxel and systemic XELOX. The primary endpoint was 1-year overall survival rate and secondary endpoints were safety, response rate, and peritoneal cytological response. Patients who subsequently had no distant metastases and two consecutive negative peritoneal cytologies underwent conversion gastrectomy if there was no macroscopic evidence of peritoneal disease at diagnostic laparoscopy. Twenty-two patients were enrolled, receiving at least one cycle of IP paclitaxel at the time of reporting (data cutoff�March 11, 2016). The median number of cycles was 7.5. The median overall survival was 18.8�months, and the 1-year survival rate was 72.2%. One patient died of neutropenic sepsis. Of 19 evaluable patients with measurable disease, 7 (36.8%) achieved PR, 8 (42.1%) achieved SD, and 4 (21.1%) experienced PD. Peritoneal cytology turned negative in 11 of 17 (64.7%) patients. Six patients underwent conversion gastrectomy (4 R0, 2 R1) with a median survival of 21.6�months (range = 8.7�29.9�months). XELOX and IP paclitaxel appears to be an effective regimen in gastric cancer with peritoneal metastases. Conversion gastrectomy may be considered in patients with a favorable response. � 2016, The Society for Surgery of the Alimentary Tract.||Source Title:||Journal of Gastrointestinal Surgery||URI:||http://scholarbank.nus.edu.sg/handle/10635/146709||ISSN:||1091255X||DOI:||10.1007/s11605-016-3336-3|
|Appears in Collections:||Staff Publications|
Show full item record
Files in This Item:
There are no files associated with this item.
checked on Jul 17, 2019
WEB OF SCIENCETM
checked on Jul 17, 2019
checked on Jul 18, 2019
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.