Tumor characteristics and clinical outcome of peritoneal metastasis of gastric origin treated with a hyperthermic intraperitoneal chemotherapy procedure in the PERISCOPE I trial

• Published in: Journal of surgical oncology Vol. 123; no. 4; pp. 904 - 910
• Main Authors: Koemans, Willem J., Kaaij, Rosa T., Wassenaar, Emma C. E., Boerma, Djamila, Boot, Henk, Sikorska, Karolina, Los, Maartje, Grootscholten, Cecile, Hartemink, Koen J., Veenhof, Alexander A. F. A., Kodach, Liudmila, Snaebjornsson, Petur, Sandick, Johanna W.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2021
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Clinical outcomes; Combined Modality Therapy; Cytoreduction Surgical Procedures - mortality; Docetaxel - administration & dosage; Female; Follow-Up Studies; Gastric cancer; HIPEC; Humans; Hyperthermia, Induced - mortality; Hyperthermic Intraperitoneal Chemotherapy - mortality; Male; Medical prognosis; Middle Aged; outcome; Oxaliplatin - administration & dosage; pathology; peritoneal metastasis; Peritoneal Neoplasms - secondary; Peritoneal Neoplasms - therapy; Prognosis; Stomach Neoplasms - pathology; Stomach Neoplasms - therapy; Surgery; survival; Survival Rate; pathology; HIPEC; gastric cancer; peritoneal metastasis; outcome; survival
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26366

Introduction The PERISCOPE I (Treatment of PERItoneal dissemination in Stomach Cancer patients with cytOreductive surgery and hyPErthermic intraperitoneal chemotherapy) study was conducted to investigate the safety and feasibility of hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients with limited peritoneal dissemination. In this study, tumor characteristics and clinical outcome of the patients treated in the PERISCOPE I trial were investigated. Methods Patients who had undergone the full study protocol were selected; that is, preoperative systemic chemotherapy, followed by a surgical procedure consisting of a (sub)total gastrectomy, cytoreductive surgery, and HIPEC with oxaliplatin (460 mg/m2) and docetaxel (in escalating doses). Results Twenty‐five PERISCOPE I patients underwent the full study protocol. Most patients had an ypT3‐4 tumor (96%) and the diffuse‐type histology was predominant (64%). Seven patients (28%) had a microscopically irradical (R1) resection. In all patients, a complete cytoreduction was achieved. Median follow‐up was 37 (95% confidence interval [CI]: 34–39) months. Disease recurrence was detected in 17 patients (68%). Median disease‐free and overall survival were 12 and 15 months, respectively. Conclusion In this series of gastric cancer patients with limited peritoneal dissemination who underwent HIPEC surgery, unfavorable tumor characteristics were common. Survival might be encouraging but disease recurrence was frequent. The efficacy of an HIPEC procedure in improving prognosis is currently being investigated in the PERISCOPE II trial.