J Gastric Cancer.  2020 Mar;20(1):50-59. 10.5230/jgc.2020.20.e6.

Multicenter Retrospective Analysis of Intraperitoneal Paclitaxel and Systemic Chemotherapy for Advanced Gastric Cancer with Peritoneal Metastasis

• Kim DW
• Jee YS
• Kim CH
• Kim JJ
• Park S
• Choi SI
• Park JM
• Kim JH
• PIPS-GC (Perioperative Intra-Peritoneal & Systemic Chemotherapy for Gastric Cancer) study group

• KMID: 2471925
• DOI: http://doi.org/10.5230/jgc.2020.20.e6

Abstract

PURPOSE
The objective of the present retrospective analysis was to describe the experience of intraperitoneal (IP) paclitaxel and systemic chemotherapy in patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC) in a multicenter setting in Korea.
MATERIALS AND METHODS
The medical records of patients with AGC, who were diagnosed with PM between January 2015 and December 2018, were reviewed. IP catheter was placed in the pouch of Douglas and was used for the administration of IP paclitaxel chemotherapy.
RESULTS
We reviewed the clinical outcomes of IP paclitaxel and systemic chemotherapy administration in 82 patients at six institutions in Korea. Mean number of IP chemotherapy cycles was 6.6. The mean peritoneal cancer index (PCI) was 21.9. Postoperative complications related to IP catheter and port were observed in 15 patients. The overall median survival was 20.0 months. A significant difference was observed in the survival rate according to the ascites grade (grade I and II, 24.1 months; grade III and IV, 15.3 months; P=0.014) and PCI grade (grade I, 25.6 months; grade II and III, 16.3 months; P=0.023).
CONCLUSIONS
The feasibility of IP paclitaxel and systemic chemotherapy administration was demonstrated in this experience-based retrospective analysis suggesting that the procedure is beneficial in patients with PM of AGC.

Keyword

Intraperitoneal chemotherapy; Peritoneal metastasis; Advanced gastric cancer

MeSH Terms

Ascites
Catheters
Drug Therapy*
Humans
Korea
Medical Records
Neoplasm Metastasis*
Paclitaxel*
Postoperative Complications
Retrospective Studies*
Stomach Neoplasms*
Survival Rate
Paclitaxel

Figure

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  Fig. 1 X-ray of intraperitoneal port and catheter.

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  Fig. 2 OS according to the types of systemic chemotherapy.OS = overall survival; XELOX = capecitabine and oxaliplatin; FOLFOX = 5-fluorouracil, folinic acid, and oxaliplatin; SP = S-1 (tegafur/gimeracil/oteracil) and cisplatin; FOLFIRI = 5-fluorouracil, folinic acid, and irinotecan.

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  Fig. 3 OS according to (A) ascites grade and (B) PCI grade.OS = overall survival; PCI = peritoneal cancer index.

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  Fig. 4 Complications related to intraperitoneal approach. (A) Skin necrosis of the port site, (B) abscess of the catheter site, and (C) malposition of catheter due to kinking.

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