TY - JOUR A2 - Bencini, Lapo AU - Yonemura, Yutaka AU - Elnemr, Ayman AU - Endou, Yoshio AU - Ishibashi, Haruaki AU - Mizumoto, Akiyoshi AU - Miura, Masahiro AU - Li, Yan PY - 2012 DA - 2012/07/31 TI - Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer SP - 148420 VL - 2012 AB - Novel multidisciplinary treatment combined with neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS) and peritonectomy was developed. Ninety-six patients were enrolled. Peritoneal wash cytology was performed before and after NIPS through a port system. Patients were treated with 60 mg/m2 of oral S-1 for 21 days, followed by a 1-week rest. On days 1, 8, and 15, 30 mg/m2 of Taxotere and 30 mg/m2 of cisplatin with 500 mL of saline were introduced through the port. NIPS is done 2 cycles before surgery. Three weeks after NIPS, 82 patients were eligible to intend cytoreductive surgery (CRS) by gastrectomy + D2 dissection + periotnectomy to achieve complete cytoreduction. Sixty-eight patients showed positice cytology before NIPS, and the positive cytology results became negative in 47 (69%) patients after NIPS. Complete pathologic response on PC after NIPS was experienced in 30 (36.8%) patients. Stage migration was experienced in 12 patients (14.6%). Complete cytoreduction was achieved in 58 patients (70.7%). By the multivariate analysis, complete cytoreduction and pathologic response became a significantly good survival. However the high morbidity and mortality, stringent patient selection is important. The best indications of the therapy are patients with good pathologic response and PCI6, which are supposed to be removed completely by peritonectomy. SN - 2090-1402 UR - https://doi.org/10.1155/2012/148420 DO - 10.1155/2012/148420 JF - International Journal of Surgical Oncology PB - Hindawi Publishing Corporation KW - ER -