Nampoolsuksan Chawisa, Parakonthun Thammawat
Siriraj Upper Gastrointestinal Cancer Center, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
World J Clin Oncol. 2025 Aug 24;16(8):107533. doi: 10.5306/wjco.v16.i8.107533.
Gastric cancer with peritoneal carcinomatosis (PC) remains a formidable challenge in oncological care, especially regarding surgical intervention. Integrating enhanced recovery after surgery (ERAS) protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach. This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure. Recent evidence suggests that ERAS, comprising multimodal strategies, improves postoperative recovery, reduces complications, and enhances quality of life. It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy. Mechanistically, ERAS promotes early mobilization, attenuates postoperative immunosuppression, and supports timely adjuvant therapies, which are crucial in managing carcinomatosis. This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits. Large-scale, prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort. Further research will facilitate ongoing advancements in oncological surgery and perioperative care, ultimately improving outcomes for patients with gastric cancer and PC.
伴有腹膜癌转移（PC）的胃癌仍然是肿瘤治疗中的一项艰巨挑战，尤其是在手术干预方面。将术后加速康复（ERAS）方案整合到胃癌根治术、细胞减灭术及热灌注化疗中已成为一种很有前景的方法。这篇综述探讨了ERAS在这一复杂手术过程中对手术及肿瘤学结局的影响。近期证据表明，包含多模式策略的ERAS可改善术后恢复、减少并发症并提高生活质量。它还可能通过将围手术期发病率降至最低，从而促进辅助治疗的及时启动，进而有助于获得更好的生存结局。从机制上讲，ERAS可促进早期活动、减轻术后免疫抑制并支持及时进行辅助治疗，这些对于控制癌转移至关重要。这篇综述强调了多学科协作及个体化患者护理对于最大化ERAS益处的重要性。有必要开展大规模的前瞻性研究来验证这些发现，并针对这一特殊患者群体完善ERAS方案。进一步的研究将推动肿瘤外科手术及围手术期护理的持续进步，最终改善胃癌伴PC患者的预后。
