Κατεύθυνση Χειρουργική Ογκολογία
Library of the School of Health Sciences

2021-03-28

2021

Kimpizi Athina-Despoina

Δημήτριος Θεοδώρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Γεώργιος Ζωγράφος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Γ. Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

HIPEC στον καρκίνο του στομάχου

Greek

HIPEC in gastric cancer

Gastric cancer constitutes the third most common malignancy worldwide and the third most common cause of death due to malignancy. The incidence of the disease differs depending on the area, the race and the gender. The prognosis as well as the treatment options depend largely on the stage of the disease. Patients with peritoneal carcinomatosis due to gastric cancer were traditionally treated solely with systemic chemotherapy. However, the cancer deposits in the peritoneal cavity do not respond well to systemic chemotherapy. This traces back to the cavity not being readily accessible to the systemically administered chemotherapeutic agents, due to its anatomical and physiological characteristics. Experts proposed during the last few decades a different approach consisting of cytoreductive surgery and intraperitoneal chemotherapy. Both the cytoreductive surgery and the intraperitoneal chemotherapy have their own unique principles and require specific design. The purpose of this study is to contemplate this approach, using the clinical studies conducted in the last decade as a starting point. It especially focuses on the survival benefit of the combination of cytoreductive surgery and intraoperative administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC). As it seems, this more aggressive therapeutic design may have a positive impact on survival, when considering carefully chosen subgroups of patients. The extent of the peritoneal disesase (PCI score) and the completeness of cytoreduction (CC score) constitute the most important prognostic factors and guide clinical decisions and the design of the treatment protocols. Such protocols for combating peritoneal disease in patients with gastric cancer have been proposed by many experts. They incorporate neoadjuvant chemotherapy, cytoreduction, different forms of intraperitoneal chemotherapy and advuvant therapy. These emerging therapeutic approaches are being investigated in evolving randomized clinical trials, such as GASTRICHIP, GASTRIPEC, DRAGON II and PERISCOPE II trials. Peritoneal disease should be individualized according to the patient characteristics by multidisciplinary teams in specialized centres.

Health Sciences

Gastric cancer, Stomach cancer, Peritoneal carcinomatosis, Intraperitoneal chemotherapy, HIPEC

Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2940195