title: Peritoneal carcinomatosis in patients with gastric cancer, and the role for surgical resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy.
abstract: BACKGROUND
  The aims of this study were to create a model of peritoneal carcinomatosis in patients with gastric cancer and to evaluates outcomes in patients with gastric cancer treated using surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).
  
  
  METHODS
  A single-institution cohort of patients with gastric cancer was analyzed according to the development of gastric cancer with peritoneal carcinomatosis (GCPC). Variables were evaluated using regression analysis. Kaplan-Meier analysis was used to evaluate outcomes after surgical resection, cytoreductive surgery, and HIPEC.
  
  
  RESULTS
  Age ≤60 years and local tumor stage (T3/T4) were significantly associated with GCPC (odds ratio, 3.95 and 3.94, respectively). Thirty-six-month survival was 57% for patients without peritoneal disease and 39% for patients with GCPC. There was no significant trend of improved survival after surgical management or HIPEC.
  
  
  CONCLUSIONS
  Age ≤60 years and T3/T4 tumor stage are risk factors for GCPC. Intermediate-term survival of patients with GCPC treated with surgical resection or cytoreductive surgery and HIPEC was not improved, though future research should address the possible benefits of aggressive approaches to the treatment of GCRC.
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Chow
authors.affiliation: Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Kunal
authors.initials: K
authors.lastname: Parikh
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Sima
authors.initials: S
authors.lastname: Blank
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Ghalib
authors.initials: G
authors.lastname: Jibara
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Hena
authors.initials: H
authors.lastname: Kadri
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Labow
authors.affiliation: Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA. Electronic address: spiros.hiotis@mountsinai.org.
authors.forename: Spiros P
authors.initials: SP
authors.lastname: Hiotis
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
keywords: Cytoreductive surgery; Gastric cancer; HIPEC; Hyperthermic intraperitoneal chemotherapy; Peritoneal carcinomatosis; Surgical resection