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Sugarbaker. J Cancer Metastasis Treat 2018;4:7                      Journal of Cancer
               DOI: 10.20517/2394-4722.2017.67                           Metastasis and Treatment




               Review                                                                        Open Access


               Gastric cancer: prevention and treatment of
               peritoneal metastases

               Paul H. Sugarbaker

               Center for Gastrointestinal Malignancies, Program in Peritoneal Surface Oncology, MedStar Washington Hospital Center,
               Washington, DC 20010, USA.
               Correspondence to: Dr. Paul H. Sugarbaker, Center for Gastrointestinal Malignancies, Program in Peritoneal Surface Oncology,
               MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC 20010, USA.
               E-mail: Paul.Sugarbaker@medstar.net

               How to cite this article: Sugarbaker PH. Gastric cancer: prevention and treatment of peritoneal metastases. J Cancer Metastasis Treat
               2018;4:7. http://dx.doi.org/10.20517/2394-4722.2017.67
               Received: 25 Nov 2017    First Decision: 3 Jan 2018    Revised: 8 Jan 2018    Accepted: 18 Jan 2018    Published: 9 Feb 2018

               Science Editor: Masayuki Watanabe    Copy Editor: Jun-Yao Li    Production Editor: Huan-Liang Wu



               Abstract
               Gastric cancer is an aggressive malignancy that may metastasize through the bloodstream to the liver, through lymphatics
               to regional lymph nodes, or by penetration of the peritoneal lining of the stomach to result in seeding of the abdominal
               and pelvis surfaces. Peritoneal metastases are the most common mode of cancer dissemination. Technologies to prevent
               or treat peritoneal metastases from advanced gastric cancer are presented in this manuscript. The world’s literature, both
               recent and over the past three decades, was reviewed in order to identify publications that present information regarding
               gastric cancer peritoneal metastases. Over one dozen randomized controlled trials to test perioperative chemotherapy
               for prevention of peritoneal metastases were reviewed. All of the trials performed with regional chemotherapy during or
               shortly after gastrectomy were positive. The clinical data regarding the treatment of peritoneal metastases diagnosed
               at the time of primary cancer resection or in follow-up were reviewed. Neoadjuvant intraperitoneal and systemic
               chemotherapy shows that some long-term survivors occur after these treatments were combined with cytoreductive
               surgery and gastrectomy. Similar treatments are advocated for primary gastric cancer with cytology positive for gastric
               cancer but no visible implants. Surgery for gastric cancer should be combined with perioperative systemic and regional
               chemotherapy in order to maximally benefit patients with this disease by reducing the negative impact of peritoneal
               metastases on survival.

               Keywords: Hyperthermic intraperitoneal chemotherapy, normothermic intraoperative intraperitoneal chemotherapy,
               early postoperative intraperitoneal chemotherapy, intraperitoneal chemotherapy, gastric cancer, peritoneal metastases,
               carcinomatosis






                           © The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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