AB194. Cytoreductive surgery and heated intraperitoneal chemotherapy for gastric cancer peritoneal metastases
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AB194. Cytoreductive surgery and heated intraperitoneal chemotherapy for gastric cancer peritoneal metastases

Ciara Conaty, Prabir Brouha, Faraz Khan, Nisha Jagasia, Conor Shields, John Conneely, Gerry McEntee, Jurgen Mulsow, Orla McCormack

Peritoneal Malignancy Unit, Mater Misericordiae University Hospital, Dublin, Ireland


Background: At presentation, 50% of patients with gastric cancer have metastases (40% of which are peritoneal metastases). The median survival, without treatment, is 3–7 months with a 5-year survival of 0%. Palliative chemotherapy improves the median survival to one year. Heated intraperitoneal chemotherapy (HIPEC) was first described as a treatment for gastric cancer patients in 1989. Multiple studies have assessed it’s validity. In 2019, a randomised multicentre trial demonstrated a significant benefit with a median overall survival of 18.6 months and a 5-year survival of 20.2% (4).

Methods: A gastric cancer program was started at the peritoneal malignancy unit at the Mater Misericordiae hospital in July 2019. Advice from other international centres was sought in devising a protocol for patients. Patients are assessed based on their age, fitness, treatment history, extent of disease on initial presentation and response to treatment.

Results: Five patients have undergone treatment. The average age was 60 years. All patients received neoadjuvant chemotherapy. Three of 5 patients had washings that were cytology positive only, the remaining two had peritoneal deposits. At theatre 4/5 patients required extended resections which included either spleen, pancreas, or colon. One patient had a grade 3 complication [anastomotic leak requiring interventional radiology (IR) drain]. The average length of operation was 7.5 hours. The average length of stay was 22 days. All patients had poorly differentiated lymph node positive adenocarcinoma with a poor tumour regression grade. Eighty percent had adjuvant treatment.

Conclusions: Cytoreductive surgery and HIPEC is safe in selected patients with peritoneal metastases from gastric cancer.

Keywords: Cytoreductive; gastric; malignancy; metastases; peritoneal


doi: 10.21037/map.2020.AB194
Cite this abstract as: Conaty C, Brouha P, Khan F, Jagasia N, Shields C, Conneely J, McEntee G, Mulsow J, McCormack O. Cytoreductive surgery and heated intraperitoneal chemotherapy for gastric cancer peritoneal metastases. Mesentery Peritoneum 2020;4:AB194.