Conversion Therapy for Gastric Cancer with Peritoneal Metastasis

Thita Intralawan; Asada Methasate; Thammawat  Parakonthun; Chawisa  Nampoolsuksan; Voraboot Taweerutchana; Atthaphorn Trakarnsanga; Chainarong Phalanusitthepha; Jirawat Swangsri; Thawatchai Akaraviputh; Vitoon Chinswangwatanakul

Siriraj Medical Journal (Aug 2024)

Conversion Therapy for Gastric Cancer with Peritoneal Metastasis

Thita Intralawan,
Asada Methasate,
Thammawat Parakonthun,
Chawisa Nampoolsuksan,
Voraboot Taweerutchana,
Atthaphorn Trakarnsanga,
Chainarong Phalanusitthepha,
Jirawat Swangsri,
Thawatchai Akaraviputh,
Vitoon Chinswangwatanakul

Affiliations

Thita Intralawan: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Asada Methasate: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Siriraj Upper Gastrointestinal Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
Thammawat Parakonthun: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Siriraj Upper Gastrointestinal Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
Chawisa Nampoolsuksan: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Siriraj Upper Gastrointestinal Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
Voraboot Taweerutchana: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Atthaphorn Trakarnsanga: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Chainarong Phalanusitthepha: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Jirawat Swangsri: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Siriraj Upper Gastrointestinal Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
Thawatchai Akaraviputh: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Vitoon Chinswangwatanakul: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Journal volume & issue: Vol. 76, no. 8

Abstract

Read online

Peritoneal metastasis in gastric cancer has a poor prognosis and is increasing in prevalence. Neoadjuvant chemotherapy is used for advanced tumors; however, surgery is generally not considered for metastatic and unresectable diseases. Recently, conversion surgery, a treatment which aims for an R0 resection following chemotherapy, has become a novel therapeutic option with better survival rates. In addition to surgery, hyperthermic intraperitoneal chemotherapy (HIPEC) leads to significant tumor reduction, but it is limited by its morbidity. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) delivers high concentrations of chemotherapy, but does not remove the tumor, making it useful mostly in palliative settings. Intraperitoneal (IP) therapy, known for its minimally invasive nature and repeatability, shows promise but requires further research. Ultimately, an integrated approach involving systemic chemotherapy, radical gastrectomy, HIPEC, PIPAC and IP chemotherapy can be used to optimize treatment outcomes of gastric cancer patients with peritoneal metastasis.

Published in Siriraj Medical Journal

ISSN: 2228-8082 (Online)
Publisher: Faculty of Medicine Siriraj Hospital
Country of publisher: Thailand
LCC subjects: Medicine
Website: https://he02.tci-thaijo.org/index.php/sirirajmedj/about

About the journal

Abstract

Keywords