Impact of preoperative chemotherapy as initial treatment for advanced gastric cancer with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) or localized peritoneal metastasis (P1a): a multi-institutional retrospective study
Background Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monot...
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| Vydané v: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Ročník 24; číslo 3; s. 701 - 709 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Singapore
Springer Singapore
01.05.2021
Springer Nature B.V |
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| ISSN: | 1436-3291, 1436-3305, 1436-3305 |
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| Abstract | Background
Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a.
Methods
We retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment.
Results
A total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others (
n
= 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87–1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85–1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group.
Conclusions
Although, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0. |
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| AbstractList | Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a.
We retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment.
A total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others (n = 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87-1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85-1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group.
Although, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0. Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a.BACKGROUNDGastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a.We retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment.METHODSWe retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment.A total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others (n = 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87-1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85-1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group.RESULTSA total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others (n = 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87-1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85-1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group.Although, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0.CONCLUSIONSAlthough, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0. BackgroundGastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a.MethodsWe retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment.ResultsA total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others (n = 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87–1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85–1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group.ConclusionsAlthough, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0. Background Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) and/or localized peritoneal metastasis (P1a), gastrectomy followed by S1 monotherapy is one of the most widely accepted therapeutic strategy in Japan. This study investigated the efficacy of preoperative chemotherapy as initial treatment in GC patients with CY1 and/or P1a. Methods We retrospectively reviewed GC patients diagnosed with CY1 and/or P1a at 34 institutions in Japan between 2008 and 2012. Selection criteria were: adenocarcinoma, no distant metastasis except CY1 or P1a, and no prior treatment. The subjects were divided into an Initial-Chemotherapy group and an Initial-Surgery group, according to the initial treatment. Results A total of 824 patients were collected and 713 eligible patients were identified for this study. As the initial treatment, 150 patients received chemotherapy (Initial-Cx), and 563 patients underwent surgery (Initial-Sx). Initial-Cx regimens were cisplatin plus S1/docetaxel plus cisplatin plus S1/others ( n = 90/37/23). Both overall survival (OS) and progression-free survival (PFS) were similar between the Initial-Cx and Initial-Sx groups (median OS 24.8 and 24.0 months, HR 1.07, 95% CI 0.87–1.3; median PFS 14.9 and 13.9 months, HR 1.04, 95% CI 0.85–1.27). The 5-year OS rates were 22.3% in the Initial-Cx group and 21.5% in the Initial-Sx group. Conclusions Although, the preoperative chemotherapy did not show a survival benefit for GC patients with CY1 and/or P1a, initial-Cx showed favorable survival in patients who converted to P0 and CY0. |
| Author | Matsushita, Hisayuki Hosoda, Kei Kinoshita, Takahiro Yamada, Tatsuya Satoh, Taroh Yamaguchi, Toshifumi Fukagawa, Takeo Terashima, Masanori Tanaka, Ryo Kakihara, Naoki Nishikawa, Kazuhiro Katai, Hitoshi Boku, Narikazu Aizawa, Masaki Nagashima, Kengo Ohashi, Manabu Haruta, Shusuke Takashima, Atsuo Ishiyama, Koshiro Yunome, Gen Yuasa, Yasuhiro |
| Author_xml | – sequence: 1 givenname: Toshifumi surname: Yamaguchi fullname: Yamaguchi, Toshifumi organization: Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital – sequence: 2 givenname: Atsuo orcidid: 0000-0002-8456-1248 surname: Takashima fullname: Takashima, Atsuo email: atakashi@ncc.go.jp organization: Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital – sequence: 3 givenname: Kengo surname: Nagashima fullname: Nagashima, Kengo organization: Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics – sequence: 4 givenname: Masanori surname: Terashima fullname: Terashima, Masanori organization: Division of Gastric Surgery, Shizuoka Cancer Center – sequence: 5 givenname: Masaki surname: Aizawa fullname: Aizawa, Masaki organization: Department of Gastroenterological Surgery, Niigata Cancer Center Hospital – sequence: 6 givenname: Manabu surname: Ohashi fullname: Ohashi, Manabu organization: Department of Gastroenterological Surgery, Cancer Institute Hospital – sequence: 7 givenname: Ryo surname: Tanaka fullname: Tanaka, Ryo organization: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital – sequence: 8 givenname: Tatsuya surname: Yamada fullname: Yamada, Tatsuya organization: Department of Gastroenterological Surgery, Saitama Cancer Center – sequence: 9 givenname: Takahiro surname: Kinoshita fullname: Kinoshita, Takahiro organization: Gastric Surgery Division, National Cancer Center Hospital East – sequence: 10 givenname: Hisayuki surname: Matsushita fullname: Matsushita, Hisayuki organization: Department of Surgery, Tochigi Cancer Center – sequence: 11 givenname: Koshiro surname: Ishiyama fullname: Ishiyama, Koshiro organization: Department of Surgery, Yamagata Prefectural Central Hospital – sequence: 12 givenname: Kei surname: Hosoda fullname: Hosoda, Kei organization: Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine – sequence: 13 givenname: Yasuhiro surname: Yuasa fullname: Yuasa, Yasuhiro organization: Department of Gastroenterological Surgery, Tokushima Red Cross Hospital – sequence: 14 givenname: Shusuke surname: Haruta fullname: Haruta, Shusuke organization: Department of Gastroenterological Surgery, Toranomon Hospital – sequence: 15 givenname: Naoki surname: Kakihara fullname: Kakihara, Naoki organization: Department of Surgery, Japanese Red Cross Kyoto Daini Hospital – sequence: 16 givenname: Kazuhiro surname: Nishikawa fullname: Nishikawa, Kazuhiro organization: Department of Surgery, National Hospital Organization Osaka National Hospital – sequence: 17 givenname: Gen surname: Yunome fullname: Yunome, Gen organization: Department of Surgery, Sendai Medical Center – sequence: 18 givenname: Taroh surname: Satoh fullname: Satoh, Taroh organization: Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine – sequence: 19 givenname: Takeo surname: Fukagawa fullname: Fukagawa, Takeo organization: Department of Surgery, Teikyo University School of Medicine – sequence: 20 givenname: Hitoshi surname: Katai fullname: Katai, Hitoshi organization: Division of Gastric Surgery, National Cancer Center Hospital – sequence: 21 givenname: Narikazu surname: Boku fullname: Boku, Narikazu organization: Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33179192$$D View this record in MEDLINE/PubMed |
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Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal... Gastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal metastasis... BackgroundGastric cancer (GC) patients with peritoneal metastasis are defined as stage IV in the Japanese classification of GC. For patients with peritoneal... |
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| SubjectTerms | Abdominal Surgery Adenocarcinoma Adult Aged Aged, 80 and over Cancer Research Cellular biology Chemotherapy Cisplatin Cytology Female Gastrectomy Gastric cancer Gastroenterology Humans Japan Male Medical Records Medicine Medicine & Public Health Metastases Metastasis Middle Aged Neoadjuvant Therapy Neoplasm Metastasis Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - therapy Oncology Original Article Patients Peritoneal Lavage Peritoneal Neoplasms - mortality Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Peritoneum Retrospective Studies Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - therapy Surgery Surgical Oncology Survival Survival Analysis Treatment Outcome Young Adult |
| Title | Impact of preoperative chemotherapy as initial treatment for advanced gastric cancer with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) or localized peritoneal metastasis (P1a): a multi-institutional retrospective study |
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