Tumor characteristics and clinical outcome of peritoneal metastasis of gastric origin treated with a hyperthermic intraperitoneal chemotherapy procedure in the PERISCOPE I trial

Willem J Koemans; Rosa T van der Kaaij; Emma C E Wassenaar; Djamila Boerma; Henk Boot; Karolina Sikorska; Maartje Los; Cecile Grootscholten; Koen J Hartemink; Alexander A F A Veenhof; Liudmila Kodach; Petur Snaebjornsson; Johanna W van Sandick

doi:10.1002/jso.26366

Tumor characteristics and clinical outcome of peritoneal metastasis of gastric origin treated with a hyperthermic intraperitoneal chemotherapy procedure in the PERISCOPE I trial

J Surg Oncol. 2021 Mar;123(4):904-910. doi: 10.1002/jso.26366. Epub 2021 Jan 11.

Affiliations

¹ Department of Surgical Oncology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
² Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
³ Department of Gastrointestinal Oncology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
⁴ Department of Biometrics, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
⁵ Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, The Netherlands.
⁶ Department of Pathology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

PMID: 33428786
DOI: 10.1002/jso.26366

Abstract

Introduction: The PERISCOPE I (Treatment of PERItoneal dissemination in Stomach Cancer patients with cytOreductive surgery and hyPErthermic intraperitoneal chemotherapy) study was conducted to investigate the safety and feasibility of hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients with limited peritoneal dissemination. In this study, tumor characteristics and clinical outcome of the patients treated in the PERISCOPE I trial were investigated.

Methods: Patients who had undergone the full study protocol were selected; that is, preoperative systemic chemotherapy, followed by a surgical procedure consisting of a (sub)total gastrectomy, cytoreductive surgery, and HIPEC with oxaliplatin (460 mg/m² ) and docetaxel (in escalating doses).

Results: Twenty-five PERISCOPE I patients underwent the full study protocol. Most patients had an ypT3-4 tumor (96%) and the diffuse-type histology was predominant (64%). Seven patients (28%) had a microscopically irradical (R1) resection. In all patients, a complete cytoreduction was achieved. Median follow-up was 37 (95% confidence interval [CI]: 34-39) months. Disease recurrence was detected in 17 patients (68%). Median disease-free and overall survival were 12 and 15 months, respectively.

Conclusion: In this series of gastric cancer patients with limited peritoneal dissemination who underwent HIPEC surgery, unfavorable tumor characteristics were common. Survival might be encouraging but disease recurrence was frequent. The efficacy of an HIPEC procedure in improving prognosis is currently being investigated in the PERISCOPE II trial.

Keywords: HIPEC; gastric cancer; outcome; pathology; peritoneal metastasis; survival.

Publication types

Clinical Trial, Phase I
Clinical Trial, Phase II
Multicenter Study

MeSH terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Combined Modality Therapy
Cytoreduction Surgical Procedures / mortality*
Docetaxel / administration & dosage
Female
Follow-Up Studies
Humans
Hyperthermia, Induced / mortality*
Hyperthermic Intraperitoneal Chemotherapy / mortality*
Male
Middle Aged
Oxaliplatin / administration & dosage
Peritoneal Neoplasms / secondary*
Peritoneal Neoplasms / therapy
Prognosis
Stomach Neoplasms / pathology*
Stomach Neoplasms / therapy
Survival Rate

Substances

Oxaliplatin
Docetaxel