Early Postoperative Intraperitoneal Chemotherapy for Macroscopically Serosa-Invading Gastric Cancer Patients
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PurposePeritoneal recurrence is one of the most common patterns of recurrence after gastric cancersurgery and it has a poor prognosis despite all efforts. The aim of this study is to evaluatethe prognostic impact of early postoperative intraperitoneal chemotherapy (EPIC) aftersurgery with curative intent for macroscopically serosa-invading gastric cancer patients. Materials and MethodsThe records of 245 patients under the age of 70 were reviewed. These patients weresuffering from macroscopically seroa-invading gastric cancer and they underwent curativesurgery from 1995 to 2004 at the Kyungpook National University Hospital, Daegu, Korea. The overall survival, gastric cancer-specific survival, complications, and patterns of recurrencewere compared between the patients who were treated with EPIC and those whowere not. ResultsEPIC was administered to 65 patients, and the remaining 180 patients did not receive thistreatment. The 5-year overall and gastric cancer-specific survival rates for the EPIC groupwere 47.4% and 53.1%, respectively, and those for the non-EPIC group were 26.7% and29.7%, respectively (p=0.012 for overall survival and p=0.011 for gastric cancer-specificsurvival). The rates of peritoneal recurrence for the EPIC group and the non-EPIC group were18.5% and 32.2%, respectively (p=0.038). There were no significant differences in themorbidity or mortality between the two groups. Based on a multivariate analysis of thefactors with prognostic significance in univariate analyses, EPIC, pathological lymph nodemetastasis, differentiation, and the extent of gastric resection were independent prognosticfactors. ConclusionThe use of EPIC to treat gastric cancer patients with macroscopic serosal invasions resultedin better survival rate by reducing the risk of peritoneal recurrence.
Abstract
PurposePeritoneal recurrence is one of the most common patterns of recurrence after gastric cancersurgery and it has a poor prognosis despite all efforts. The aim of this study is to evaluatethe prognostic impact of early postoperative intraperitoneal chemotherapy (EPIC) aftersurgery with curative intent for macroscopically serosa-invading gastric cancer patients. Materials and MethodsThe records of 245 patients under the age of 70 were reviewed. These patients weresuffering from macroscopically seroa-invading gastric cancer and they underwent curativesurgery from 1995 to 2004 at the Kyungpook National University Hospital, Daegu, Korea. The overall survival, gastric cancer-specific survival, complications, and patterns of recurrencewere compared between the patients who were treated with EPIC and those whowere not. ResultsEPIC was administered to 65 patients, and the remaining 180 patients did not receive thistreatment. The 5-year overall and gastric cancer-specific survival rates for the EPIC groupwere 47.4% and 53.1%, respectively, and those for the non-EPIC group were 26.7% and29.7%, respectively (p=0.012 for overall survival and p=0.011 for gastric cancer-specificsurvival). The rates of peritoneal recurrence for the EPIC group and the non-EPIC group were18.5% and 32.2%, respectively (p=0.038). There were no significant differences in themorbidity or mortality between the two groups. Based on a multivariate analysis of thefactors with prognostic significance in univariate analyses, EPIC, pathological lymph nodemetastasis, differentiation, and the extent of gastric resection were independent prognosticfactors. ConclusionThe use of EPIC to treat gastric cancer patients with macroscopic serosal invasions resultedin better survival rate by reducing the risk of peritoneal recurrence.
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