caa a22 4500 445339004 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1770-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1770-8 Neoadjuvant Intraperitoneal and Systemic Chemotherapy for Gastric Cancer Patients with Peritoneal Dissemination [Elektronische Daten] [Yoshiyuki Fujiwara, Shuji Takiguchi, Kiyokazu Nakajima, Hiroshi Miyata, Makoto Yamasaki, Yukinori Kurokawa, Kaoru Okada, Masaki Mori, Yuichiro Doki] Background: The present study was designed to assess the feasibility and efficiency of intraperitoneal and intravenous neoadjuvant chemotherapy in gastric cancer patients with peritoneal dissemination. Methods: The study subjects were 25 treatment-naïve patients with gastric cancer. Patients with positive cytology or with peritoneal carcinomatosis received neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), comprising intraperitoneal (i.p.) mitomycin C (MMC) and cisplatin (CDDP), followed by two cycles of intravenous triplet chemotherapy of docetaxel, 5-fluorouracil (5-FU), and CDDP. Gastrectomy with lymph node dissection was performed after NIPS in patients free of peritoneal deposits, confirmed by staging laparoscopy. Results: Seventeen patients had measurable lymph node metastases by the RECIST criteria. CT examination showed response to the treatment in ten (59%, 0 complete response, 10 partial response). Of the 25 patients, 14 (56%) showed negative results on peritoneal cytology with no macroscopic peritoneal metastasis, whereas the remaining 11 were cancer cell-positive on peritoneal cytology or macroscopic peritoneal metastasis even after NIPS. The median survival time for all 25 patients was 16.7months. Prognosis was better in patients who showed negative cytology and disappearance of peritoneal cancer metastases after NIPS than in those with positive cytology or existing peritoneal deposits (P<0.0001). The predominant toxicity was myelosuppression and grade 3-4 leukopenia and neutropenia occurred in 20 (80%) patients, which were manageable. No treatment-related mortality was observed during and after NIPS and surgery. Conclusions: The results of this prospective phase II study indicated that the newly designed NIPS was highly effective and well tolerated in patients with advanced gastric cancer and peritoneal dissemination. Society of Surgical Oncology, 2011 Fujiwara Yoshiyuki Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Takiguchi Shuji Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Nakajima Kiyokazu Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Miyata Hiroshi Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Yamasaki Makoto Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Kurokawa Yukinori Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Okada Kaoru Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Mori Masaki Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Doki Yuichiro Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3726-3731 1068-9265 18:13<3726 2011 18 10434 https://doi.org/10.1245/s10434-011-1770-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1770-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujiwara Yoshiyuki Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Takiguchi Shuji Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nakajima Kiyokazu Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Miyata Hiroshi Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Yamasaki Makoto Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kurokawa Yukinori Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Okada Kaoru Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Mori Masaki Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Doki Yuichiro Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3726-3731 1068-9265 18:13<3726 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer