Optimizing outcomes for patients with gastric cancer peritoneal carcinomatosis

Table 1 Studies with positive cytology or low volume peritoneal carcinomatosis

Ref.	Patient No.	Treatment group(s)	Intraperitoneal regimen	Systemic regimen	Outcomes
Aizawa et al[17], 2015	47	NA systemic chemo	--	Variable	48.9% converted to negative cytology
					Negative cytology Median OS: 30.4 mo	Positive cytology Median OS: 15.0 mo
Badgwell et al[18], 2017	19	NA systemic chemo, then NLHIPEC, then gastrectomy if peritoneal disease cleared	MMC and cisplatin	Variable	36.8% converted to negative cytology or had clearance of PC Entire cohort median OS: 30.2 mo
Fujiwara et al[19], 2011	25	NA systemic and IP chemo → gastrectomy if peritoneal disease cleared	MMC and cisplatin	IV docetaxel, 5-fu, cisplatin	56% converted to negative cytology or had clearance of PC
					Negative Median OS: 27.1 mo	Positive Median OS: 9.6 mo
Ishigami et al[20], 2009	40	NA systemic and IP chemo	Paclitaxel	IV paclitaxel and oral S-1	Median OS: 22.5 mo

NA: Neoadjuvant; chemo: Chemotherapy; OS: Overall survival; NLHIPEC: Neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy; MMC: Mitomycin C; PC: Peritoneal carcinomatosis; IP: Intraperitoneal; IV: Intravenous; 5-FU: 5-fluorouracil.

Table 2 Studies for peritoneal carcinomatosis with cytoreductive surgery

Ref.	Patient No.	Treatment group(s)	Intraperitoneal regimen	Systemic regimen	Outcomes
Bonnot et al[30], 2018	277	CRS alone vs CRS + HIPEC	1	1	CRS Alone Median OS: 12.1 mo		CRS + HIPEC Median OS: 12.1 mo
Yang et al[31], 2011	68	CRS alone vs CRS + HIPEC	Cisplatin and MMC	-	CRS Alone Median OS: 6.5 mo		CRS + HIPEC Median OS: 11.0 mo
Glehen et al[32], 2010	159	CRS with PIC (HIPEC or EPIC)	Variable	-	Median OS: 9.2 mo
Rudloff et al[33], 2014	16	CRS/HIPEC/SC vs SC alone	Oxaliplatin	FOLFOXIRI	SC Alone 4.3 mo	CRS/HIPEC/SC Median OS: 11.3 mo
Canbay et al[34], 2014	194	NA systemic and IP chemo, then CRS and HIPEC if responsive	Docetaxel and cisplatin	Oral S-1	78.3% had negative cytology and underwent CRS and HIPEC
					No response (no CRS or HIPEC) Median OS: 7.5 mo	Response (CRS with HIPEC) Median OS: 15.8 mo
Yonemura et al[38], 2017	105	NLHIPEC → CRS or NLHIPEC → NIPS → CRS	Docetaxel and cisplatin	Oral S-1, IV docetaxel and cisplatin	NLHIPEC + CRS Median OS: 14.1 mo PCI: 14.2 → 11.8	NLHIPEC + NIPS + CRS Median OS: 19.2 mo PCI: 14.8 → 9.9

¹Abstract only, agents used not included. CRS: Cytoreductive surgery; HIPEC: Hyperthermic intraperitoneal chemotherapy; OS: Overall survival; MMC: Mitomycin C; PIC: Perioperative chemotherapy; EPIC: Early postoperative intraperitoneal chemotherapy; SC: Systemic chemotherapy; NA: Neoadjuvant; IP: Intraperitoneal; NLHIPEC: Neoadjuvant laparoscopic HIPEC; NIPS: Neoadjuvant intraperitoneal and systemic chemotherapy; PCI: Peritoneal carcinomatosis index.

Table 3 Immunotherapy studies

Ref.	Patient No.	Treatment group(s)	Intraperitoneal regimen	Systemic regimen	Outcomes
Heiss et al[45], 2010	66	Paracentesis + catumaxomab vs Paracentesis alone	Catumaxomab	-	Paracentesis Alone Median OS: 44 d	Paracentesis + Catumaxomab Median OS: 71 d
Bokemeyer et al[46], 2015	54	NA chemotherapy, surgery, intra- and post-op catumaxomab	Catumaxomab	Variable	4 yr DFS: 38% 4 yr OS: 50%

OS: Overall survival; NA: Neoadjuvant; DFS: Disease free survival.