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Mura et al. J Cancer Metastasis Treat 2016;2:365-74 Journal of
DOI: 10.20517/2394-4722.2016.19
Cancer Metastasis and Treatment

www.jcmtjournal.com
Review Open Access

The features of peritoneal metastases from

gastric cancer

Gianni Mura , Beatrice Verdelli 2
1
1 Department of Surgery, Valdarno Hospital, 52100 Arezzo, Italy.
2 Department of Radiology, Valdarno Hospital, 52100 Arezzo, Italy.
Correspondence to: Dr. Gianni Mura, Department of Surgery, Valdarno Hospital, Via Cimabue n.19, 52100 Arezzo, Italy.
E-mail: gianmura@gmail.com
How to cite this article: Mura G, Verdelli B. The features of peritoneal metastases from gastric cancer. J Cancer Metastasis Treat 2016;2:365-74.

Dr. Gianni Mura is a Surgical Oncologist, General and Emergency Surgeon, and Gastro-intestinal Endoscopist.
Since 1996 he focused his interest on surgical oncology, with experience in: loco-regional therapies for advanced-
stage abdominal cancers as the Early Post-operative Intraperitoneal Chemotherapy (EPIC) and the Hypoxic
Chemo-perfusion (Stop-Flow); Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
for peritoneal carcinomatosis; Sentinel Node Biopsy for early gastric cancer; extended nodal dissection and neo-
adjuvant chemotherapy for advanced gastric cancer; surgery and adjuvant therapies for metastatic melanoma;
clinical research.
ABSTRACT

Article history: Peritoneal Carcinomatosis (PC) from metastasization of Gastric Cancer (GC), either
Received: 18-04-2016 present at first diagnosis of GC or as recurrence, is considered a fatal disease with no
Accepted: 19-07-2016 hope of definitive cure. Although newer agents like S1 and docetaxel have shown some
Published: 18-09-2016 promise, the median overall survival with the current first line chemotherapy is only 8
to 14 months, and is not greatly improved by adding targeted therapy. A multi-modal
Key words: approach with cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal
Gastric cancer, chemotherapy (HIPEC) has been developed along the last two decades in order to tackle
peritoneal carcinomatosis, this problem. It’s an aggressive, combined treatment still under investigation. Studies
hyperthermic intraperitoneal coming from Europe and Far East reported long-term survival with 5-year survival rates
chemotherapy, up to nearly 25% in case of complete cytoreduction. Prophylactic/adjuvant setting is the
immunotherapy, most evidence-based indication for HIPEC in advanced-stage GC patients without PC,
reverse transcription-polymerase in order to prevent peritoneal recurrence and to improve overall survival. The rationale
chain reaction for immuno treatment in patients with gastric PC is strong. A randomized phase II study,
combining complete CRS with intraperitoneal catumaxomab is on-going. The detection of
free peritoneal cancer cells is the more realistic and practical way for the identification of
patients at risk of carcinomatosis after surgery. The routine use of techniques of molecular
detection in peritoneal washing appears to be the more sensitive method. Such patients
are potential candidate for multimodal and locoregional treatments in order to prevent the
peritoneal recurrence.
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