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21.06.2019 | Original Article | Ausgabe 1/2020

Gastric Cancer 1/2020

Peritoneal metastasis in gastric cancer: results from the German database

Zeitschrift:
Gastric Cancer > Ausgabe 1/2020
Autoren:
Beate Rau, Andreas Brandl, Pompiliu Piso, Jörg Pelz, Peter Busch, Cedric Demtröder, Silke Schüle, Hans-Jürgen Schlitt, Marc Roitman, Jürgen Tepel, Udo Sulkowski, Faik Uzunoglu, Michael Hünerbein, Rüdiger Hörbelt, Michael Ströhlein, Stefan Beckert, Ingmar Königsrainer, Alfred Königsrainer, for the Peritoneum Surface Oncology Group and members of the StuDoQ|Peritoneum Registry of the German Society for General and Visceral Surgery (DGAV)
Wichtige Hinweise
Beate Rau, Andreas Brandl are contributed equally to this manuscript.

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Abstract

Background

Patients with peritoneal metastases of gastric cancer have a poor prognosis with a median survival of 7 months. A benefit of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could be shown in several selected patient cohorts but remains controversial. The aim of this study was, to reflect the results of a national German HIPEC registry initiated by the German Society of General and Visceral Surgery (DGAV).

Methods

The DGAV HIPEC registry StuDoQ|Peritoneum documents patients with peritoneal malignancy contributed from 52 hospitals. All consecutive documented patients from 2011 until 2016 (n = 3078) were treated with CRS and HIPEC and were analysed. A total of 315 (10%) suffered from gastric cancer and were analysed.

Results

A complete data set of 235 patients was available for this study, including 113 male (48.1%) and 122 female (51.9%) patients with a median age of 53.4 years (SD ± 11.9). The median PCI was 8.0 (range 1–30). A complete cytoreduction was achieved in 121 patients (71.6%). Postoperative complications (Clavien–Dindo grades 3–4) occurred in 40 patients (17%). The median overall survival (OS) time was 13 months. The 5-year survival rate was 6%. According to the PCI from 0–6 (n = 74); 7–15 (n  = 70) and 16–39 (n = 24) the median OS differs significantly (18 months vs. 12 months vs. 5 months; p = 0.002).

Conclusions

CRS and HIPEC in selected patients with gastric cancer and peritoneal spread can improve survival when they are treated in centers. An accurate staging and patient selection are of major importance to achieve long-term survival.

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