title: Evolution and emerging future of cytoreducxtive surgery and hyperthermic intraperitoneal chemoperfusion in gastric cancer: From treating the incurable to preventing recurrence.
abstract: The number of new gastric cancer (GC) cases is decreasing, and these patients have longer survival thanks to new oncological treatments. In advanced GC a common evolution of this neoplasm is peritoneal metastases (PM). In the past this finding meant no chance for cure. However, today, using high quality operations and HIPEC, we are able to increase the number of patients treated with curative intention. New options in the diagnosis of PM, tumour susceptibility for different drugs, importance of quality of life, usage in ascites treatment, diagnostic tools in image-guided surgery, new targeted therapies and analysis of currently ongoing trials are presented together with today's knowledge of HIPEC efficacy in order to evaluate gastric PM. HIPEC is an effective tool in the treatment of selected patients with PM from GC. Together with new diagnostic options such as targeted therapies, HIPEC may improve the prognosis of these patients, not only by treating clinically manifest carcinomatosis, but also in the prophylactic setting, addressing occult peritoneal seeding.
authors.affiliation: a Department of Medicine , Surgery and Neurosciences, University of Siena .
authors.forename: Karol
authors.initials: K
authors.lastname: Polom
authors.affiliation: b General, Minimally Invasive and Robotic Surgery, Department of Surgery, 'San Matteo degli Infermi' Hospital , Spoleto , and.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.affiliation: c Department of Oncology , University of Siena , Siena , Italy.
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
authors.affiliation: c Department of Oncology , University of Siena , Siena , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Petrioli
authors.affiliation: a Department of Medicine , Surgery and Neurosciences, University of Siena .
authors.forename: Riccardo
authors.initials: R
authors.lastname: Piagnerelli
authors.affiliation: a Department of Medicine , Surgery and Neurosciences, University of Siena .
authors.forename: Lorenzo
authors.initials: L
authors.lastname: de Franco
authors.affiliation: a Department of Medicine , Surgery and Neurosciences, University of Siena .
authors.forename: Daniele
authors.initials: D
authors.lastname: Marrelli
authors.affiliation: a Department of Medicine , Surgery and Neurosciences, University of Siena .
authors.forename: Franco
authors.initials: F
authors.lastname: Roviello
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D006801:Humans; D006979:Hyperthermia, Induced; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000628:therapy*; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Ascites; HIPEC; gastric cancer; intraperitoneal chemotherapy; near infrared fluorescence; targeted therapies