Rau Beate, Feldbrügge Linda, Gronau Felix, Alberto Vilchez Miguel Enrique, Thuss-Patience Peter, Bonnot Pierre Emmanuel, Glehen Olivier
Department of Surgery, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Chirurgische Klinik Campus Charité Mitte | Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin, Germany.
Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumour Immunologie Campus Virchow Klinikum, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Universitätsmedizin, Berlin, Germany.
Visc Med. 2022 Apr;38(2):81-89. doi: 10.1159/000522604. Epub 2022 Feb 23.
Gastric cancer (GC) is associated with a poor prognosis mostly due to peritoneal metastasis, which will develop in time during the patient's disease history. To prevent and treat peritoneal metastasis, different kinds of treatment regimens have been described.
In this review, we addressed two main topics - prophylaxis and treatment of peritoneal metastasis in GC. Prevention should be directed towards diminishing cancer cell spillage and reducing adherence of cancer cells to the abdominal cavity. Postoperative washing of the abdomen with or without chemotherapy and additional heat are herein discussed.
Treatment of existing peritoneal metastasis is effective in patients with limited disease and tumour spread. Cytoreductive surgery including resection of peritoneal metastasis followed directly with hyperthermic intraperitoneal chemotherapy can increase overall survival and progression-free survival in selected patients. Drugs, duration and time schedules of intraperitoneal chemotherapy are reviewed and presented. Intraperitoneal chemotherapy seems to improve the prognosis of patients with GC and peritoneal metastasis after complete resection of both primary and metastatic tumours.
胃癌（GC）的预后较差，主要原因是腹膜转移，这会在患者病程中逐渐出现。为了预防和治疗腹膜转移，人们描述了不同的治疗方案。
在本综述中，我们探讨了两个主要主题——胃癌腹膜转移的预防和治疗。预防应旨在减少癌细胞的溢出并降低癌细胞与腹腔的黏附。本文讨论了术后用或不用化疗及附加热疗进行腹腔冲洗的情况。
对于疾病和肿瘤扩散有限的患者，现有腹膜转移的治疗是有效的。减瘤手术，包括切除腹膜转移灶，然后直接进行腹腔热灌注化疗，可提高部分患者的总生存期和无进展生存期。本文回顾并介绍了腹腔化疗的药物、持续时间和时间表。腹腔化疗似乎可改善原发性和转移性肿瘤均完全切除后胃癌伴腹膜转移患者的预后。
