A systematic review and meta-analysis of gastric cancer treatment in patients with positive peritoneal cytology
Tóm tắt
Gastric cancer patients with positive peritoneal cytology as the only marker of metastatic disease have poor prognoses. There is no universal consensus on the most appropriate treatment regimen for this particular patient group. We reviewed and analyzed published data to determine the optimal treatment regimen for patients with peritoneal cytology-positive gastric adenocarcinomas. Six electronic databases were explored [PubMed, Cochrane (Systematic Reviews and Controlled Trials), PROSPERO, DARE, and EMBASE]. The primary outcome was overall survival with secondary outcomes including patterns of recurrence and treatment-related morbidity. Six studies were included for data extraction. There was no significant heterogeneity between studies. The use of S1 monotherapy was associated with a significant survival benefit (HR 0.48; 95 % CI 0.32–0.70; p = 0.0002). Intraoperative intraperitoneal chemotherapy (IIPC) with adjuvant chemotherapy showed a trend toward improvement in overall survival (HR 0.70; 95 % CI 0.47–1.04; p = 0.08). A recent randomized controlled trial examining extensive intraperitoneal lavage (EIPL) with IIPC showed a significant improvement in overall survival (5-year overall survival, 43.8 % for EIPL-IPC group compared with 4.6 % for IPC group). However, these promising results need to be validated in larger prospective randomized trials.
Tài liệu tham khảo
Leake P-A, Cardoso R, Seevaratnam R, et al. A systematic review of the accuracy and indications for diagnostic laparoscopy prior to curative-intent resection of gastric cancer. Gastric Cancer. 2011;15(S1):38–47. doi:10.1007/s10120-011-0047-z.
Leake P-A, Cardoso R, Seevaratnam R, et al. A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer. Gastric Cancer. 2011;15(S1):27–37. doi:10.1007/s10120-011-0071-z.
Bentrem D, Wilton A, Mazumdar M, Brennan M, Coit D. The value of peritoneal cytology as a preoperative predictor in patients with gastric carcinoma undergoing a curative resection. Ann Surg Oncol. 2005;12(5):1–7.
Chang L, Stefanidis D, Richardson WS, Earle DB, Fanelli RD. The role of staging laparoscopy for intraabdominal cancers: an evidence-based review. Surg Endosc. 2009;23(2):231–41. doi:10.1007/s00464-008-0099-2.
Yonemura Y, Endou Y, Sasaki T, et al. Surgical treatment for peritoneal carcinomatosis from gastric cancer. Eur J Surg Oncol (EJSO). 2010;36(12):1131–8. doi:10.1016/j.ejso.2010.09.006.
Jarlais Des DC, Lyles C, Crepaz N. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94(3):361–6.
Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2012;10(1):28–55. doi:10.1016/j.ijsu.2011.10.001.
Parmar MKB, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17(24):2815–34.
Kuramoto M, Shimada S, Ikeshima S, et al. Extensive intraoperative peritoneal lavage as a standard prophylactic strategy for peritoneal recurrence in patients with gastric carcinoma. Ann Surg. 2009;250(2):242–6. doi:10.1097/SLA.0b013e3181b0c80e.
Imano M, Imamoto H, Itoh T, et al. Impact of intraperitoneal chemotherapy after gastrectomy with positive cytological findings in peritoneal washings. Eur Surg Res. 2011;47(4):254–9. doi:10.1159/000333803.
Shimada S, Tanaka E, Marutsuka T, et al. Short communication: extensive intraoperative peritoneal lavage and chemotherapy for gastric cancer patients with peritoneal free cancer cells. Gastric Cancer. 2002;5:168–72.
Yonemura Y, Endou Y, Bando E, et al. The usefulness of oral TS-1 treatment for potentially curable gastric cancer patients with intraperitoneal free cancer cells. Cancer Therapy. 2006;4:135–42.
Kodera Y, Ito S, Mochizuki Y, et al. A phase II study of radical surgery followed by postoperative chemotherapy with S-1 for gastric carcinoma with free cancer cells in the peritoneal cavity (CCOG0301 study). Eur J Surg Oncol (EJSO). 2009;35(11):1158–63. doi:10.1016/j.ejso.2009.03.003.
Ako E, Ohira M, Yamashita Y, et al. Efficacy of S-1 for gastric cancer patients with positive peritoneal lavage cytology. Hepatogastroenterology. 2008;55:1939–42.
Heslin M, Latkany L, Leung D. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg. 1997;226:567–80.
Badgwell B, Cormier JN, Krishnan S, et al. Does neoadjuvant treatment for gastric cancer patients with positive peritoneal cytology at staging laparoscopy improve survival? Ann Surg Oncol. 2008;15(10):2684–91. doi:10.1245/s10434-008-0055-3.
Mezhir JJ, Shah MA, Jacks LM, Brennan MF, Coit DG, Strong VE. Positive peritoneal cytology in patients with gastric cancer: natural history and outcome of 291 patients. Ann Surg Oncol. 2010;17(12):3173–80. doi:10.1245/s10434-010-1183-0.
Lorenzen S, Panzram B, Rosenberg R, et al. Prognostic significance of free peritoneal tumor cells in the peritoneal cavity before and after neoadjuvant chemotherapy in patients with gastric carcinoma undergoing potentially curative resection. Ann Surg Oncol. 2010;17(10):2733–9. doi:10.1245/s10434-010-1090-4.
Bando E, Yonemura Y, Takeshita Y, et al. Intraoperative lavage for cytological examination in 1,297 patients with gastric carcinoma. Am J Surg. 1999;178:256–62.
Oh CA, Bae JM, Oh SJ, et al. Long-term results and prognostic factors of gastric cancer patients with only positive peritoneal lavage cytology. J Surg Oncol. 2012;105(4):393–9. doi:10.1002/jso.22091.
Kodera Y, Nakanishi H, Ito S, et al. Prognostic significance of intraperitoneal cancer cells in gastric carcinoma: analysis of real time reverse transcriptase-polymerase chain reaction after 5 years of follow-up. J Am Coll Surg. 2006;202(2):231–6. doi:10.1016/j.jamcollsurg.2005.09.008.
Nakagawa S, Nashimoto A, Yabusaki H. Role of staging laparoscopy with peritoneal lavage cytology in the treatment of locally advanced gastric cancer. Gastric Cancer. 2007;10(1):29–34. doi:10.1007/s10120-006-0406-3.
Fukagawa T, Katai H, Saka M, et al. Significance of lavage cytology in advanced gastric cancer patients. World J Surg. 2010;34(3):563–8. doi:10.1007/s00268-009-0355-1.
Saito H, Kihara K, Kuroda H, Matsunaga T, Tatebe S, Ikeguchi M. Surgical outcomes for gastric cancer patients with intraperitoneal free cancer cell, but no macroscopic peritoneal metastasis. J Surg Oncol. 2011;104(5):534–7. doi:10.1002/jso.21983.
Nath J, Moorthy K, Taniere P, Hallissey M, Alderson D. Peritoneal lavage cytology in patients with oesophagogastric adenocarcinoma. Br J Surg. 2008;95(6):721–6. doi:10.1002/bjs.6107.
Los G, Mutsaers PH, van der Vijgh WJ. Direct diffusion of cis-diamminedichloroplatinum(II) in intraperitoneal rat tumors after intraperitoneal chemotherapy: a comparison with systemic chemotherapy. Cancer Res. 1989;49:3380–4.
Wagner AD. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24(18):2903–9. doi:10.1200/JCO.2005.05.0245.
Sano T. Adjuvant and neoadjuvant therapy of gastric cancer a comparison of three pivotal studies. Curr Oncol Rep. 2008;10:191–8.
Sano T. We have entered a new era of adjuvant/neoadjuvant therapy for gastric cancer. Gastrointest Cancer Res. 2008;1(4):156–7.
Oshima T, Yamada R, Hatori S, Kunisake C, Toshio I. Pharmacokinetics of S-1 in patients with peritoneal dissemination of gastric cancer. Oncol Rep. 2006;16:361–6.
Iwasaki Y, Ohashi M, Iwanaga T, et al. Therapeutic strategy for gastric cancer with positive peritoneal lavage cytology without peritoneal dissemination. Gan Kagaku Ryoho Cancer Chemother. 2012;39:2451–4.
Ito S, Kodera Y, Mochizuki Y, Kojima T, Nakanishi H, Yamamura Y. Phase II clinical trial of postoperative S-1 monotherapy for gastric cancer patients with free intraperitoneal cancer cells detected by real-time RT-PCR. World J Surg. 2010;34(9):2083–9. doi:10.1007/s00268-010-0573-6.
Ajani JA, Rodriguez W, Bodoky G, et al. Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol. 2010;28(9):1547–53. doi:10.1200/JCO.2009.25.4706.
Ajani JA, Faust J, Ikeda K, Yao JC, Anbe H. Phase I pharmacokinetic study of S-1 plus cisplatin in patients with advanced gastric carcinoma. J Clin Oncol. 2005;23(28):6957–65. doi:10.1200/JCO.2005.01.917.
Yan TD, Black D, Sugarbaker PH, et al. A systematic review and meta-analysis of the randomized controlled trials on adjuvant intraperitoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol. 2007;14(10):2702–13. doi:10.1245/s10434-007-9487-4.
Takahashi I, Emi Y, Hasuda S, et al. Clinical application of hyperthermia combined with anticancer drugs for the treatment of solid tumors. Surgery (St. Louis). 2002;131(1):S78–84. doi:10.1067/msy.2002.119308.
Tsujitani S, Fukuda K, Saito H, et al. The administration of hypotonic intraperitoneal cisplatin during operation as a treatment for the peritoneal dissemination of gastric cancer. Surgery (St. Louis). 2002;131(1):S98–104. doi:10.1067/msy.2002.119359.
Kaibara N. Prophylaxis and treatment of peritoneal metastasis from gastric cancer. Nihon Geka Gakkai Zasshi. 1996;97(4):308–11.
Huguet EL, Keeling NJ. Distilled water peritoneal lavage after colorectal cancer surgery. Dis Colon Rectum. 2004;47(12):2114–9. doi:10.1007/s10350-004-0788-4.
Shimada S, Kuramoto M, Marutsuka T, Yagi Y, Baba H. Adopting extensive intra-operative peritoneal lavage (EIPL) as the standard prophylactic strategy for peritoneal recurrence. Rev Recent Clin Trials. 2011;6:266–70.
Ito F, Camoriano M, Seshadri M, Evans SS, Kane JM, Skitzki JJ. Water: a simple solution for tumor spillage. Ann Surg Oncol. 2011;18(8):2357–63. doi:10.1245/s10434-011-1588-4.
Han T-S, Kong S-H, Lee H-J, et al. Dissemination of free cancer cells from the gastric lumen and from perigastric lymphovascular pedicles during radical gastric cancer surgery. Ann Surg Oncol. 2011;18(10):2818–25. doi:10.1245/s10434-011-1620-8.
Misawa K, Mochizuki Y, Ohashi N, et al. A randomized phase III trial exploring the prognostic value of extensive intraoperative peritoneal lavage in addition to standard treatment for resectable advanced gastric cancer: CCOG 1102 study. Jpn J Clin Oncol. 2014;44(1):101–3. doi:10.1093/jjco/hyt157.
Marutsuka T, Shimada S, Shiomori K, et al. Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis. Clin Cancer Res. 2003;9:678–85.
Ishii T, Fujiwara Y, Ohnaka S, et al. Rapid genetic diagnosis with the transcription? Reverse transcription concerted reaction system for cancer micrometastasis. Ann Surg Oncol. 2004;11(8):778–85. doi:10.1245/ASO.2004.12.043.
Mori T, Fujiwara Y, Sugita Y, et al. Application of molecular diagnosis for detection of peritoneal micrometastasis and evaluation of preoperative chemotherapy in advanced gastric carcinoma. Ann Surg Oncol. 2006;11(1):14–20. doi:10.1245/as0.2004.02.016.