Feasibility of a "Stomach-preserving Strategy" for Perforated Gastric Cancer in Patients With Distant Metastasis.

IF 1.8 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
In vivo Pub Date : 2025-03-01 DOI:10.21873/invivo.13902
Masayoshi Terayama, Koshi Kumagai, Motonari Ri, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Manabu Ohashi, Takeshi Sano, Souya Nunobe
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引用次数: 0

Abstract

Background/aim: Gastrectomy is often performed for perforated gastric cancer in patients receiving treatment with curative intent. However, gastrectomy is not a curative procedure, precludes oral intake, and may hinder palliative chemotherapy in patients with metastatic disease. The present study assessed the feasibility of a "stomach-preserving strategy" comprising peritoneal lavage and repair surgery for the management of gastric cancer perforation in patients with distant metastasis.

Patients and methods: We retrospectively reviewed the medical records of patients with gastric cancer who underwent surgical treatment at our hospital from 2013 to 2021. The clinical courses of patients who had undergone peritoneal lavage and repair surgery for perforated gastric cancer with distant metastasis were reviewed to evaluate postoperative outcomes.

Results: During the study period, 3,862 patients underwent radical gastrectomy. Additionally, nine patients with stage IV gastric cancer with distant metastasis prior to treatment underwent emergency surgery due to gastric perforation. Of the nine patients that underwent emergency surgery, seven patients underwent peritoneal lavage and repair surgery and two underwent peritoneal lavage only. No cases of secondary leakage were observed. Seven patients (78%) had a good postoperative course including the resumption of meals and continuation of chemotherapy. The remaining two died of sepsis. The median overall survival time was five months from surgery and 12 months from the initiation of palliative chemotherapy.

Conclusion: A "stomach-preserving strategy" for the management of perforated gastric cancer is safe in patients with stage IV gastric cancer with distant metastasis and allows continuation of oral intake and palliative chemotherapy.

远距离转移穿孔胃癌“保胃策略”的可行性。
背景/目的:以治愈为目的接受治疗的穿孔胃癌患者常行胃切除术。然而,胃切除术不是一种治愈性手术,排除了口服摄入,并可能阻碍转移性疾病患者的姑息性化疗。本研究评估了一种“保胃策略”的可行性,该策略包括腹膜灌洗和修复手术,用于治疗远处转移的胃癌穿孔。患者和方法:回顾性分析我院2013年至2021年接受手术治疗的胃癌患者病历。本文回顾了胃癌穿孔并远处转移患者行腹腔灌洗修复手术的临床过程,以评价其术后疗效。结果:在研究期间,3862例患者接受了根治性胃切除术。此外,9例治疗前伴有远处转移的IV期胃癌患者因胃穿孔而进行了紧急手术。在接受紧急手术的9例患者中,7例患者接受了腹膜灌洗和修复手术,2例患者仅接受了腹膜灌洗。未见二次渗漏。7例(78%)患者术后恢复饮食和继续化疗的过程良好。其余两人死于败血症。中位总生存期为手术后5个月和开始姑息性化疗后12个月。结论:对于有远处转移的IV期胃癌穿孔患者,“保胃策略”是安全的,并且允许继续口服摄入和姑息性化疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
In vivo
In vivo 医学-医学:研究与实验
CiteScore
4.20
自引率
4.30%
发文量
330
审稿时长
3-8 weeks
期刊介绍: IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.
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