title: The treatment of peritoneal carcinomatosis in advanced gastric cancer: state of the art.
abstract: Gastric cancer (GC) is the fourth most common cancer and the second leading cause of cancer death in the world; 53-60% of patients show disease progression and die of peritoneal carcinomatosis (PC). PC of gastric origin has an extremely inauspicious prognosis with a median survival estimate at 1-3 months. Different studies presented contrasting data about survival rates; however, all agreed with the necessity of a complete cytoreduction to improve survival. Hyperthermic intraperitoneal chemotherapy (HIPEC) has an adjuvant role in preventing peritoneal recurrences. A multidisciplinary approach should be empowered: the association of neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), cytoreductive surgery (CRS), HIPEC, and early postoperative intraperitoneal chemotherapy (EPIC) could increase the rate of completeness of cytoreduction (CC) and consequently survival rates, especially in patients with Peritoneal Cancer Index (PCI) ≤6. Neoadjuvant chemotherapy may improve survival also in PC from GC and adjuvant chemotherapy could prevent recurrence. In the last decade an interesting new drug, called Catumaxomab, has been developed in Germany. Two studies showed that this drug seems to improve progression-free survival in patients with GC; however, final results for both studies have still to be published.
authors.affiliation: General Surgery Department, Spedali Civili, Chirurgia Generale 3, Piazzale Spedali Civili, 25121 Brescia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Montori
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, 42121 Bergamo, Italy.
authors.forename: Federico
authors.identifier: 0000-0001-6364-4186
authors.initials: F
authors.lastname: Coccolini
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, 42121 Bergamo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ceresoli
authors.affiliation: Emergency Surgery Department, Ospedale Maggiore, 43121 Parma, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, 42121 Bergamo, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Colaianni
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, 42121 Bergamo, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Poletti
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, 42121 Bergamo, Italy.
authors.forename: Luca
authors.identifier: 0000-0001-6427-0307
authors.initials: L
authors.lastname: Ansaloni
mesh_terms: D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome