Conversion surgery for gastric cancer with limited peritoneal carcinomatosis

Conversion surgery for disseminated gastric cancer is attracting increasing attention as a new therapeutic strategy. A number of European and Asian studies on this topic have presented data on the advantage of performing cytoreductive surgery in a limited group of patients. Objective. To evaluate the safety and efficacy of conversion surgery for gastric cancer with limited peritoneal carcinomatosis. Material and methods. In the period from 2015 to 2022, 45 cytoreductive surgical interventions in patients with limited peritoneal carcinomatosis (PCI ≤7) in gastric cancer were performed in National Medical Radiology Research Center. Results. After preoperative drug treatment, 24 cases showed complete regression of carcinomatosis foci confirmed histologically and cytologically, while the remaining cases achieved partial response or stabilization. Surgical intervention was supplemented with hyperthermic intraoperative intra-abdominal chemotherapy or sessions of intra-abdominal aerosol chemotherapy. The extent of cytoreduction was considered as R0/CC-0 in 38 (84%) of 45 patients. Median overall survival was 24.1 months, with overall one-and two-year survival rates of 84.4 and 52%, respectively. Conclusion. Analysis of the results of conversion surgery for gastric cancer with limited peritoneal carcinomatosis has demonstrated the safety and efficacy of this approach with careful selection of patients. Further recruitment and analysis of the accumulated experience will make it possible to clarify the criteria for selecting patients for conversion surgery, as well as the optimal regimens of perioperative drug treatment. © 2024, Media Sphera Publishing Group. All rights reserved.