Objective To understand research progress on peritoneal metastasis from gastric cancer at present stage briefly. Methods The literatures about mechanism, diagnosis, prevention and treatment of the peritoneal metastasis from gastric cancer at home and aboard were collected to make a review. Results The peritoneal metastasis is the common site of the distant metastasis in the advanced gastric cancer. It’s occurrence mechanism is complex, the diagnostic measure is varied, the prevention way is difficulty, and it give priority to with the comprehensive treatment and the transformed therapy. Conclusion It has a certain necessity to study occurrence mechanism, prevention methods and treatment measures so that improve survival rate and prognosis for patients with peritoneal metastasis from advanced gastric cancer.
Objective To detect expressions of CD31 and D2-40 in patients with simultaneous colorectal cancer with peritoneal metastasis and investigate their correlation between them. Method The expressions of CD31 and D2-40 protein in these 59 cases (there were 19 and 40 patients with or without peritoneal metastasis, respectively) of colorectal cancer were detected by immunohistochemical MaxVision method. Results ① The positive rates of CD31 and D2-40 protein expression in the colorectal cancer tissues with or without peritoneal metastasis were significantly higher than those of the normal colonic tissues (P<0.05), but which had no significant differences between the colorectal cancer tissues with or without peritoneal metastasis (P>0.05). ② The CD31 microvessel density (CD31-MVD) and D2-40 lymphatic microvessel density (D2-40-LMVD) in the colorectal cancer tissues with peritoneal metastasis were significantly higher than those of the normal colonic tissues (P<0.05) and the colorectal cancer tissues without peritoneal metastasis (P<0.05). ③ The CD31-MVD and D2-40-LMVD were not associated with all the clinicopathologic characteristics of the colorectal cancer patients without peritoneal metastasis (P>0.05), but which in the poorly differentiated adenocarcinoma and mucinous and signet ring cell carcinomas patients with peritoneal metastasis were significantly higher than those of the other types (P<0.05) and were not associated with the age, gender, and diamter of the tumor of it (P>0.05). ④ There was a positive correlation between the CD31-MVD and the D2-40-LMVD in the colorectal cancer patients with or without peritoneal metastasis (r=0.342, P=0.012; r=0.119, P=0.008). Conclusions CD31-MVD and D2-40-LMVD in colorectal cancer patients with peritoneal metastasis highly express and has a positive correlation, which means that they might have a certain relationship with peritoneal metastasis. There may be some common regulation way and collaboratively participate peritoneal metastasis of colorectal cancer.
ObjectiveTo summarize the experience of diagnosis and treatment of a patient with liver and lung metastasis and retroperitoneal metastasis from right colon cancer.MethodsA retrospective analysis of a patient with liver, lung, and retroperitoneal metastasis from right colon cancer who received treatment at The First Affiliated Hospital of Kunming Medical University in August 2016 was conducted. In order to provide reference for domestic doctors to treat advanced colorectal cancer.ResultsAfter receiving several cycles of chemotherapy and three surgical resections of the primary and metastatic lesions before the MDT, the patient again found a retroperitoneal mass. After discussions of Department of Imaging, Oncology, Radiotherapy, and Gastrointestinal and Hernia Surgery, we thought that, at present, the treatment of the patient was mainly surgery and oral chemotherapy. So the patient underwent retroperitoneal tumor resection+abdominal adhesion release, and had been interviewed for 3 months. No recurrence or metastasis was found during follow-up.ConclusionThe therapy of liver-lung metastasis and retroperitoneal metastasis in right colon cancer are mainly based on surgical resection of lesions, postoperative combined with radiotherapy and chemotherapy, molecular targeted therapy, and postoperative monitoring of CEA changes.
ObjectiveTo explore the diagnostic value of “Four-Step Procedure” of laparoscopic exploration in patients with peritoneal metastasis of gastric cancer.MethodsWe retrospectively collected the data of 409 gastric adenocarcinoma patients from July 2016 to August 2020 who underwent “Four-Step Procedure” of laparoscopic exploration in West China Hospital. The descriptive case series study was conducted to analyze the outcome of laparoscopic exploration combined with CY (cytology test), stepwise treatment plans, and the rates of CY1 and P1 (peritoneal metastasis) among cT3–4 patients during different periods. SPSS 22.0 software was used to conduct the univariate and multivariate logistic regression to analyze the high risk factors associated with P1 and (or) CY1.ResultsA total of 409 gastric adenocarcinoma patients who underwent laparoscopic exploration were enrolled in our study. Among them, 65 patients were confirmed to be P1 and (or) CY1. Stratified analysis by cT and cN staging showed that there were 7 (7.4%) and 55 (27.9%) patients with peritoneal metastasis in cT3 staging and cT4 staging, respectively. After laparoscopic exploration, 168 patients received laparoscopic gastrectomy, 35 patients received laparotomy, 143 patients received neo-adjuvant chemotherapy, and 63 patients received conversion therapy. The bar chart showed an ascending tendency in the diagnosis rate of P1 over time among cT3–4 patients. Multivariate logistic regression analysis showed that ascites was an independent risk factor of CY1 and (or) P1 (P<0.001). Additionally, the postoperative complication rate was 2.9% in the patients who merely underwent laparoscopic exploration, including 4 patients with pulmonary infection and 2 patients with urinary retention.Conclusions“Four-Step Procedure” of laparoscopic exploration is reliable and feasible for gastric cancer. “Four-Step Procedure” of laparoscopic exploration has high diagnostic value for peritoneal metastasis of gastric cancer. Our study shows that most of peritoneal metastasis distribute in cT3 and cT4 patients. For these patients, laparoscopic exploration should be recommended to identify if peritoneal metastasis exists and avoid unnecessary laparotomy.
Gastric cancer remains one of the most prevalent and fatal malignancies in China. Peritoneal metastasis represents a frequent mode of dissemination or recurrence in patients with advanced disease and confers an extremely poor prognosis. In recent years, considerable progress has been made in imaging techniques, with modalities including CT, ultrasound, MRI and PET-CT being implemented to evaluate peritoneal metastasis. However, adequate detection remains challenging, particularly for occult peritoneal metastasis. With the advent of precision medicine, radiomics and artificial intelligence have undergone rapid development and show considerable promise for the early prediction of peritoneal metastasis in gastric cancer, providing a new means of diagnosis and treatment for patients with peritoneal metastasis.