Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2016; 22(33): 7478-7485
Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7478
Regional but fatal: Intraperitoneal metastasis in gastric cancer
Jia Wei, Nan-Die Wu, Bao-Rui Liu
Jia Wei, Nan-Die Wu, Bao-Rui Liu, Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing 210008, Jiangsu Province, China
Author contributions: Wei J and Wu ND contributed to literature review; Liu BR revised the article and all authors have read and approved the final version to be published.
Supported by National Natural Science Foundation of China, No. 81220108023, No. 81370064 and No. 81572329; Fundamental Research Funds for the Central Universities, No. 20620140729; Jiangsu Provincial Program of Medical Sciences, No. BL2012001; and Distinguished Young Investigator Project of Nanjing, No. JQX12002.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Bao-Rui Liu, MD, PhD, Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China.
Telephone: +86-25-83107081 Fax: +86-25-83317016
Received: April 18, 2016
Peer-review started: April 19, 2016
First decision: May 12, 2016
Revised: May 15, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: September 7, 2016

Peritoneal carcinomatosis appears to be the most common pattern of metastasis or recurrence and is associated with poor prognosis in gastric cancer patients. Many efforts have been made to improve the survival in patients with peritoneal metastasis. Hyperthermic intraperitoneal chemotherapy remains a widely accepted strategy in the treatment of peritoneal dissemination. Several phase II-III studies confirmed that the combined cytoreducitve surgery and hyperthermic intraperitoneal chemotherapy resulted in longer survival in patients with peritoneal carcinomatosis. In addition, proper selection and effective regional treatment in patients with high risk of peritoneal recurrence after resection will further improve prognosis in local advanced gastric cancer patients.

Keywords: Gastric cancer, Intraperitoneal metastasis, Regional metastasis, Cytoreductive surgery, Hyperthermic intraperitoneal chemotherapy

Core tip: The recurrence rate of gastric cancer after surgery within 2 years remains at 79%. Gastric cancer patients with peritoneal metastases have a median survival of only 3.1 mo. Understanding the influence of peritoneal metastasis on survival in gastric cancer patients, the potential molecular mechanism of peritoneal metastasis, and individualized treatment of patients with high risk of peritoneal metastasis is essential for selecting effective treatment strategies in advanced gastric cancer. In this review, we summarized translational and clinical researches on peritoneal carcinomatosis, providing comprehensive information to better understand the fatal role of peritoneal metastasis in gastric cancer.