{"title":"Feasibility of a \"Stomach-preserving Strategy\" for Perforated Gastric Cancer in Patients With Distant Metastasis.","authors":"Masayoshi Terayama, Koshi Kumagai, Motonari Ri, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Manabu Ohashi, Takeshi Sano, Souya Nunobe","doi":"10.21873/invivo.13902","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":13364,"journal":{"name":"In vivo","volume":"39 2","pages":"969-975"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884499/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"In vivo","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/invivo.13902","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
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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.
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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