Extensive Intraoperative Peritoneal Lavage May Not Improve OS in Gastric Cancer
Previous research suggested that EIPL may improve survival by reducing the number of intraperitoneal-free cancer cells.
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Extensive intraoperative peritoneal lavage (EIPL) may not improve disease-free survival (DFS) or overall survival (OS) among patients with T3 or worse gastric cancer, according to research being presented at the 2018 Gastrointestinal Cancers Symposium in San Francisco, California.1
Previous research suggested that EIPL may improve survival by reducing the number of intraperitoneal-free cancer cells. Researchers attempted to confirm this finding in the randomized phase 3 CCOG 1102 trial.
For CCOG 1102, researchers randomly assigned 295 patients with T3 or T4 gastric cancer to an EIPL (145 patients) or non-EIPL (150 patients) group. Patients in the EIPL group underwent peritoneal lavage with 1 liter of saline at least 10 times; patients in the non-EIPL group underwent lavage with 3 liters of saline or less.
Patients in the 2 groups had similar clinicopathologic characteristics and there was no significant differences in the rates of post-operative complications.
The 3-year DFS rates were 63.9% and 59.7% in the EIPL and non-EIPL groups, respectively (P = .25). The 3-year OS rates were 75% in the EIPL group and 73.7% in the non-EIPL group; the 5-year OS rates were 62.5% and 57.1%, respectively (P = .65). No survival differences were noted in subgroup analyses.
The authors concluded that while “EIPL for advanced gastric cancer was safe and suggested some efficacy, the primary endpoint designed based on the previous small-scale trial was not met.”
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- Morimoto D, Misawa K, Mochizuki Y, et al. Long-term outcome of a randomized phase III trial exploring the significance of extensive intraoperative peritoneal lavage in addition to standard treatment for ≥ T3 resectable gastric cancer: CCOG 1102. Oral presentation at: 2018 Gastrointestinal Cancers Symposium; January 18-20, 2018; San Francisco, CA.