General and Emergency Surgery, Santa Maria della Misericordia Hospital University of Perugia, Perugia, Italy.
General and Upper GI Surgery Division, University of Verona, Verona, Italy.
World J Surg Oncol. 2021 Nov 24;19(1):334. doi: 10.1186/s12957-021-02442-9.
The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery.
It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences.
Our results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could benefit from an aggressive surgical approach performing an extended lymphadenectomy and HIPEC treatment.
The main result of the study is that GC patients with limited peritoneal involvement can have a survival benefit from a surgery with "radical oncological intent", that means extended lymphadenectomy and R0 resection. The retrospective nature of this study is an important bias, and for this reason, we have started a prospective multicentric study including Italian stage IV patients that hopefully will give us more answers.
本研究提供了意大利胃癌腹膜转移患者的资料，这些患者在意大利胃癌研究组的意大利中心接受了手术治疗。评估了影响此类患者生存的预后因素，最终目的是确定可能从根治性手术中获益的患者。
这是一项基于前瞻性收集数据库的多中心回顾性研究，该数据库包括胃癌患者的人口统计学、临床、手术、病理和随访数据以及同步性宏观腹膜转移患者的数据。患者于 2005 年 1 月至 2017 年 1 月接受手术治疗。我们主要关注接受根治性手术治疗的有宏观腹膜癌病（PC）的患者，以提供同质的证据。
我们的结果表明，不能认为腹膜转移的患者都失去了希望。严格选择的病例（R0/R1 和 P1 患者）可以从积极的手术方法中获益，进行广泛的淋巴结清扫和 HIPEC 治疗。
该研究的主要结果是，具有有限腹膜受累的 GC 患者可以从具有“根治性肿瘤学意图”的手术中获益，即广泛的淋巴结清扫和 R0 切除。本研究的回顾性性质是一个重要的偏倚，因此，我们已经开始了一项包括意大利 IV 期患者的前瞻性多中心研究，希望能给我们更多的答案。
