MC  Vol.3 No.2 , April 2014
Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Is HIPEC the Only Answer?
ABSTRACT

Gastric cancer with peritoneal carcinomatosis is notorious for its dismal prognosis. While the pathophysiology of peritoneal dissemination is still controversial, the rapid downhill course is universal. Patients usually suffer abdominal distension, intestinal obstruction and various complications before they succumb after a median of 3 - 6 months. Although not adopted in most international treatment guidelines, intraperitoneal chemotherapy has growing evidence compared with conventional systemic chemotherapy for the treatment of peritoneal carcinomatosis. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is well-established for clinical benefit but is technically demanding with substantial treatment-related morbidities and mortality. On the other hand, normothermic intraperitoneal chemotherapy in the form of bidirectional neoadjuvant treatment is promising with various newer chemotherapeutic agents. Regardless of the treatment technique applied, the essential element of success is meticulous patient selection and availability of expertise. Future direction is along the line of personalized treatment with the application of translational science.


Cite this paper
Lam, K. , Law, B. , Law, S. and Kwong, D. (2014) Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Is HIPEC the Only Answer?. Modern Chemotherapy, 3, 11-19. doi: 10.4236/mc.2014.32003.
References
[1]   WHO (2012) All Cancers (Excluding Non-Melanoma Skin Cancer) Estimated Incidence, Mortality and Prevalence Worldwide in 2012. WHO, Geneva. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx

[2]   Mezhir, J.J., Shah, M.A., Jacks, L.M., Brennan, M.F., Coit, D.G. and Strong, V.E. (2010) Positive Peritoneal Cytology in Patients with Gastric Cancer: Natural History and Outcome of 291 Patients. Annals of Surgical Oncology, 17, 3173-3180. http://dx.doi.org/10.1245/s10434-010-1183-0

[3]   Ikeguchi, M., Oka, A., Tsujitani, S., Maeta, M. and Kaibara, N. (1994) Relationship between Area of Serosal Invasion and Intraperitoneal Free Cancer Cells in Patients with Gastric Cancer. Anticancer Research, 14, 2131-2134.

[4]   D’Angelica, M, Gonen, M., Brennan, M.F., Turnbull, A.D., Bains, M. and Karpeh, M.S. (2004) Patterns of Initial Recurrence in Completely Resected Gastric Adenocarcinoma. Annals of Surgery, 240, 808-816. http://dx.doi.org/10.1097/01.sla.0000143245.28656.15

[5]   Bang, Y.J., Kim, Y.W., Yang, H.K., Chung, H.C., Park, Y.K., Lee, K.H., et al. (2012) Adjuvant Capecitabine and Oxaliplatin for Gastric Cancer After D2 Gastrectomy (CLASSIC): A Phase 3 Open-Label, Randomized Controlled Trial. Lancet, 379, 315-321. http://dx.doi.org/10.1016/S0140-6736(11)61873-4

[6]   Sasako, M., Sakuramoto, S., Katai, H., Kinoshita, T., Furukawa, H., Yamaguchi, T., et al. (2011) Five-Year Outcomes of a Randomized Phase III Trial Comparing Adjuvant Chemotherapy with S-1 versus Surgery Alone in Stage II or III Gastric Cancer. Journal of Clinical Oncology, 29, 4387-4393.
http://dx.doi.org/10.1200/JCO.2011.36.5908

[7]   Sadeghi, B., Arvieux, C., Glehen, O., Beaujard, A.C., Rivoire, M., Baulieux, J., et al. (2000) Peritoneal Carcinomatosis from Non-Gynaecologic Malignancies: Results of the EVOCAPE 1 Multicentric Prospective Study. Cancer, 88, 358-363.
http://dx.doi.org/10.1002/(SICI)1097-0142(20000115)88:2<358::AID-CNCR16>3.0.CO;2-O

[8]   Yan, T.D., Morris, D.L., Shigeki, K., Dario, B. and Marcello, D. (2008) Preoperative Investigations in the Management of Peritoneal Surface Malignancy with Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy: Expert Consensus Statement. Journal of Surgical Oncology, 98, 224-227.
http://dx.doi.org/10.1002/jso.21069

[9]   Alakus, H., Batur, M., Schmidt, M., Drebber, U., Baldus, S.E., Vallbohmer, D., et al. (2010) Variable 18F-Fluoro-deoxyglucose Uptake in Gastric Cancer Is Associated with Different Levels of GLUT-1 Expression. Nuclear Medicine Communications, 31, 532-538.

[10]   Jacquet, P. and Sugarbaker, P.H. (1996) Clincial Research Methodologies in Diagnosis and Staging of Patients with Peritoneal Carcinomatosis. Cancer Research and Treatment, 83, 359-374.
http://dx.doi.org/10.1007/978-1-4613-1247-5_23

[11]   Harmon, R.L. and Sugarbaker, P.H. (2005) Prognostic Indicators in Peritoneal Carcinomatosis from Gastrointestinal Cancer. International Seminars in Surgical Oncology, 2, 3.
http://dx.doi.org/10.1186/1477-7800-2-3

[12]   Bang, Y.J., Van Cutsem, E., Feyereislova, A., Chung, H.C., Shen, L., Sawaki, A., et al. (2010) Trastuzumab in Combination with Chemotherapy versus Chemotherapy Alone for Treatment of HER2-Positive Advanced Gastric or Gastro-Oesophageal Junction Cancer (TOGA): A Phase 3, Open-Label, Randomized Controlled Trial. The Lancet, 376, 687-697. http://dx.doi.org/10.1016/S0140-6736(10)61121-X

[13]   National Comprehensive Cancer Network Clinical Practice Guideline in Oncology. Gastric Cancer, Version 1.2014. http://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf

[14]   Waddell, T., Verheij, M., Allum, W., Cunningham, D., Cervantes, A. and Arnold, D., European Society for Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), European Society of Radiotherapy and Oncology (ESTRO) (2013) Gastric Cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up. Annals of Oncology, 24, vi57-vi63.
http://dx.doi.org/10.1093/annonc/mdt344

[15]   Japanese Gastric Cancer Association (2011) Japanese Gastric Cancer Treatment Guidelines 2010 (ver. 3). Gastric Cancer, 14, 113-123. http://dx.doi.org/10.1007/s10120-011-0042-4

[16]   Dedrick, R.L., Myers, C.E., Bungay, P.M. and De Vita Jr., V.T. (1978) Pharmacokinetic Rationale for Peritoneal Drug Administration in the Treatment of Ovarian Cancer. Cancer Treatment Reports, 62, 1-11.

[17]   Coccolini, F., Cotte, E., Glehen, O., Lotti, M., Poiasina, E., Catena, F., et al. (2014) Intraperitoneal Chemotherapy in Advanced Gastric Cancer. Meta-Analysis of Randomized Trials. European Journal of Surgical Oncology, 40, 12-26. http://dx.doi.org/10.1016/j.ejso.2013.10.019

[18]   Sticca, R.P. and Dach, B.W. (2003) Rationale for Hyperthermia with Intraoperative Intraperitoneal Chemotherapy Agents. Surgical Oncology Clinics of North America, 12, 689-701.
http://dx.doi.org/10.1016/S1055-3207(03)00029-2

[19]   Kitayama, J. (2014) Intraperitoneal Chemotherapy against Peritoneal Carcinomatosis. Current Status and Future Perspective. Surgical Oncology, 23, 99-106. http://dx.doi.org/10.1016/j.suronc.2014.03.004

[20]   Verwaal, V.J., Bruin, S., Boot, H., van Slooten, G. and van Tinteren, H. (2008) 8-Year Follow-Up of Randomized Trial: Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy versus Systemic Chemotherapy in Patients with Peritoneal Carcinomatosis of Colorectal Cancer. Annals of Surgical Oncology, 15, 2426-2432. http://dx.doi.org/10.1245/s10434-008-9966-2

[21]   Gill, R.S., Al-Adra, D.P., Nagendran, J., Campbell, S., Shi, X., Haase, E. and Schiller, D. (2011) Treatment of Gastric Cancer with Peritoneal Carcinomatosis by Cytoreductive Surgery and HIPEC: A Systematic Review of Survival, Mortality, and Morbidity. Journal of Surgical Oncology, 104, 692-698.
http://dx.doi.org/10.1002/jso.22017

[22]   Chia, C.S., Tan, W.J., Wong, J.F., Tan, G.H., Lim, C., Wang, W., et al. (2014) Quality of Life in Patients with Peritoneal Surface Malignancies after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. European Journal of Surgical Oncology, 40, 909-916.
http://dx.doi.org/10.1016/j.ejso.2013.12.028

[23]   Tan, W.J., Wong, J.F., Chia, C.S., Tan, G.H., Soo, K.C. and Teo, M.C. (2013) Quality of Life after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: An Asian Perspective. Annals of Surgical Oncology, 20, 4219-4223. http://dx.doi.org/10.1245/s10434-013-3133-0

[24]   Zhu, Y., Hanna, N., Boutros, C. and Alexander Jr., H.R. (2012) Assessment of Clinical Benefit and Quality of Life in Patients Undergoing Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Management of Peritoneal Metastases. Journal of Gastrointestinal Oncology, 4, 62-71.
http://dx.doi.org/10.3978/j.issn.2078-6891.2012.053

[25]   Kusamura, S., Baratti, D., Hutanu, I., Rossi, P. and Deraco, M. (2012) The Importance of The Learning Curve and Surveillance of Surgical Performance in Peritoneal Surface Malignancy Programs. Surgical Oncology Clinics of North America, 21, 559-576. http://dx.doi.org/10.1016/j.soc.2012.07.011

[26]   González-Moreno, S., González-Bayón, L. and Ortega-Pérez, G. (2012) Hyperthermic Intraperitoneal Chemotherapy: Methodology and Safety Considerations. Surgical Oncology Clinics of North America, 21, 543-557. http://dx.doi.org/10.1016/j.soc.2012.07.001

[27]   Sugarbaker, P.H., Mora, J.T., Carmignani, P., Stuart, O.A. and Yoo, D. (2005) Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy. The Oncologist, 10, 112-122. http://dx.doi.org/10.1634/theoncologist.10-2-112

[28]   Yonemura, Y., Endou, Y., Shinbo, M., Sasaki, T., Hirano, M., Mizumoto, A., et al. (2009) Safety and Efficacy of Bidirectional Chemotherapy for Treatment of Patients with Peritoneal Dissemination from Gastric Cancer: Selection for Cytoreductive Surgery. Journal of Surgical Oncology, 100, 311-316.
http://dx.doi.org/10.1002/jso.21324

[29]   Yonemura, Y., Elnemr, A., Endou, Y., Ishibashi, H., Mizumoto, A., Miura, M., et al. (2012) Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer. International Journal of Surgical Oncology, 2012, 1-8. http://dx.doi.org/10.1155/2012/148420

[30]   Fujiwara, Y., Takiguchi, S., Nakajima, K., Miyata, H., Yamasaki, M., Kurokawa, Y., et al. (2011) Neoadjuvant Intraperitoneal and Systemic Chemotherapy for Gastric Cancer Patients with Peritoneal Dissemination. Annals of Surgical Oncology, 18, 3726-3731.
http://dx.doi.org/10.1245/s10434-011-1770-8

[31]   Fujiwara, Y., Takiquchi, S., Nakajima, K., Miyata, H., Yamasaki, M., Kurokawa, Y., et al. (2012) Intraperitoneal Docetaxel Combined with S-1 for Advanced Gastric Cancer with Peritoneal Dissemination. Journal of Surgical Oncology, 105, 38-42. http://dx.doi.org/10.1002/jso.22057

[32]   Kitayama, J., Ishigami, H., Yamaguchi, H., Yamashita, H., Emoto, S., Kaisaki, S., et al. (2014) Salvage Gastrectomy after Intravenous and Intraperitoneal Paclitaxel (PTX) Administration with Oral S-1 for Peritoneal Dissemination of Advanced Gastric Cancer with Malignant Ascites. Annals of Surgical Oncology, 21, 539-546. http://dx.doi.org/10.1245/s10434-013-3208-y

[33]   Yamaguchi, H., Kitayama, J., Ishigami, H., Emoto, S., Yamashita, H. and Watanabe, T. (2013) A Phase 2 Trial of Intravenous and Intraperitoneal Paclitaxel Combined Eith S-1 for Treatment of Gastric Cancer with Macroscopic Peritoneal Metastasis. Cancer, 119, 3354-3358. http://dx.doi.org/10.1002/cncr.28204

[34]   Kitayama, J., Ishigami, H., Yamaguchi, H., Yamashita, H., Emoto, S. and Kaisaki, S. (2012) S-1 Plus Intravenous and Intraperitoneal Paclitaxel for Gastric Cancer with Peritoneal Metastasis. Gastrointestinal Cancer Research, 5, S10-S13.

[35]   Ishigami, H., Kitayama, J., Kaisaki, S., Hidemura, A., Kato, M., Otani, K., et al. (2010) Phase II Study of Weekly Intravenous and Intraperitoneal Paclitaxel Combined with S-1 for Advanced Gastric Cancer with Peritoneal Metastasis. Annals of Oncology, 21, 67-70. http://dx.doi.org/10.1093/annonc/mdp260

[36]   Canbay, E., Mizumoto, A., Ichinose, M., Ishibashi, H., Sako, S., Hirano, M., et al. (2014) Outcome Data Of Patients with Peritoneal Carcinomatosis from Gastric Origin Treated by a Strategy of Bidirectional Chemotherapy Prior to Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in a Single Specialized Center in Japan. Annals of Surgical Oncology, 21, 1147-1152.
http://dx.doi.org/10.1245/s10434-013-3443-2

[37]   Fushida, S., Kinoshita, J., Kaji, M., Hirono, Y., Goda, F., Yagi, Y., et al. (2013) Phase I/II Study of Intraperitoneal Docetaxel Plus S-1 for the Gastric Cancer Patients with Peritoneal Carcinomatosis. Cancer Chemotherapy and Pharmacology, 71, 1265-1272. http://dx.doi.org/10.1007/s00280-013-2122-0

[38]   J?ger, M., Schoberth, A., Ruf, P., Hess, J., Hennig, M., Schmalfeldt, B., et al. (2012) Immunomonitoring Results of a Phase II/III Study of Malignant Ascites Patients Treated with the Trifunctional Antibody Catumaxomab (Anti-Epcam X Anti-CD3). Cancer Research, 72, 24-32. http://dx.doi.org/10.1158/0008-5472.CAN-11-2235

[39]   Heiss, M.M., Murawa, P., Koralewski, P., Kutarska, E., Kolesnik, O.O., Ivanchenko, V.V., et al. (2010) The Trifunctional Antibody Catumaxomab for the Treatment of Malignant Ascites Due to Epithelial Cancer: Results of a Prospective Randomized Phase II/III Trial. International Journal of Cancer, 127, 2209-2221. http://dx.doi.org/10.1002/ijc.25423

[40]   Wimberger, P., Gilet, H., Gonschior, A.K., Heiss, M.M., Moehler, M., Oskay-Oezcelik, G., et al. (2012) Deterioration in Quality Of Life (Qol) In Patients with Malignant Ascites: Results from a Phase II/III Study Comparing Paracentesis plus Catumaxomab with Paracentesis Alone. Annals of Oncology, 23, 1979-1985. http://dx.doi.org/10.1093/annonc/mds178

[41]   Bozzetti, C., Negri, F.V., Lagrasta, C.A., Crafa, P., Bassano, C., Tamagnini, I., et al. (2011) Comparison of HER2 Status in Primary and Paired Metastatic Sites of Gastric Carcinoma. British Journal of Cancer, 104, 1372-1376. http://dx.doi.org/10.1038/bjc.2011.121

[42]   Berretta, M., Fisichella, R., Borsatti, E., Lleshi, A., Ioffredo, S., Meneguzzo, N., et al. (2014) Feasibility of Intraperitoneal Trastuzumab Treatment in a Patient with Peritoneal Carcinomatosis from Gastric Cancer. European Review for Medical and Pharmacological Sciences, 18, 689-692.

[43]   Yagi, Y., Fushida, S., Harada, S., Tsukada, T., Kinoshita, J., Oyama, K., et al. (2009) Biodistribution of Humanized Anti-VEGF Monoclonal Antibody/Bevacizumab on Peritoneal Metastatic Models with Subcutaneous Xenograft of Gastric Cancer in Mice. Cancer Chemotherapy and Pharmacology, 66, 745-753. http://dx.doi.org/10.1007/s00280-009-1219-y

[44]   El-Shami, K., Elsaid, A. and El-Kerm, Y. (2007) Open-Label Safety and Efficacy Pilot Trial of Intraperitoneal Bevacizumab as Palliative Treatment in Refractory Malignant Ascites. Journal of Clinical Oncology, 25, 9043.

 
 
Top