Peritoneal Lavage CEA mRNA Levels Predict Conversion Gastrectomy Outcomes after Induction Chemotherapy with Intraperitoneal Paclitaxel in Gastric Cancer Patients with Peritoneal Metastasis

Autor: Hironori Yamaguchi, Hironori Ishigami, Yumiko Satoh, Joji Kitayama, Makiko Kurihara, Yutaka Yatomi
Rok vydání: 2017
Předmět:
0301 basic medicine
Oncology
Male
medicine.medical_treatment
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Carcinoembryonic antigen
Surgical oncology
Antineoplastic Combined Chemotherapy Protocols
Medicine
Peritoneal Lavage
Peritoneal Neoplasms
biology
Induction Chemotherapy
Middle Aged
Prognosis
Combined Modality Therapy
Survival Rate
Drug Combinations
Paclitaxel
030220 oncology & carcinogenesis
Female
Injections
Intraperitoneal
medicine.drug
Adult
medicine.medical_specialty
Tegafur
03 medical and health sciences
Gastrectomy
Stomach Neoplasms
Internal medicine
Humans
Clinical significance
RNA
Messenger
Aged
Retrospective Studies
business.industry
Induction chemotherapy
Carcinoembryonic Antigen
Regimen
Oxonic Acid
030104 developmental biology
chemistry
biology.protein
Surgery
Laparoscopy
business
Follow-Up Studies
Zdroj: Annals of surgical oncology. 24(11)
ISSN: 1534-4681
Popis: The outcome of gastric cancer patients with peritoneal metastasis remains poor. We treated these patients with intraperitoneal and intravenous paclitaxel plus oral S-1 (tegafur/gimeracil/oteracil), followed by gastrectomy in responders. We evaluated the clinical significance of peritoneal lavage carcinoembryonic antigen (CEA) messenger RNA (mRNA) levels as a biomarker for indication of conversion gastrectomy.The peritoneal lavage of 68 patients who received the above regimen as induction chemotherapy was repeatedly collected via intraperitoneal access ports. Gastrectomy was considered when improvement of peritoneal metastasis was confirmed by a second laparoscopic examination with negative peritoneal cytology. CEA and porphobilinogen deaminase mRNAs were chronologically quantified using the transcription reverse-transcription concerted reaction method. The CEA mRNA index (CmRI) was calculated as CEA mRNA/porphobilinogen deaminase mRNA × 10,000.Thirty-nine patients underwent gastrectomy and 29 patients did not (median survival time, 27.8 vs. 10.7 months, respectively; P 0.001). In gastrectomy-positive patients, the outcome largely differed according to CmRI values immediately prior to surgery. Patients with a preoperative CmRI value100 (n = 20) were associated with a significantly longer survival than those with a preoperative CmRI value100 (n = 19) (41.8 vs. 20.1 months, respectively; P 0.001). A preoperative CmRI value100 was confirmed as an independent predictor of survival for gastrectomy-positive patients in the multivariate analysis.The CmRI reflects the response of peritoneal metastases to induction intraperitoneal chemotherapy. It may be a useful biomarker for indicating gastrectomy in gastric cancer patients with peritoneal metastasis.
Databáze: OpenAIRE
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