Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis

doi:10.16139/j.1007-9610.2025.04.01

Journal of Surgery Concepts & Practice ›› 2025, Vol. 30 ›› Issue (04): 277-294.doi: 10.16139/j.1007-9610.2025.04.01

• Consensus and guideline • Next Articles

Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis

ZHU Zhenggang^1a^,^*(), Joji Kitayama²^,^*, Hyung-Ho Kim³^,^*, Jimmy Bok-Yan So⁴^,^*, CAO Hui⁵, CHEN Lin⁶, CHENG Xiangdong⁷, HU Jiankun⁸, Motohiro Imano⁹, Hironori Ishigami¹⁰, Ye Seob Jee¹¹, Jong-Han Kim¹², Yasuhiro Kodera¹³, LIANG Han¹⁴, LIU Xiaowen¹⁵, LU Sheng^1a, MOU Yiping¹⁶, NIE Mingming¹⁷, Won Jun Seo¹⁸, WANG Yanong¹⁵, WU Dan¹⁹, XU Zekuan²⁰, Hironori Yamaguchi²¹, YAN Chao^1a, YANG Zhongyin^1a, YIN Kai¹⁷, Yutaka Yonemura²², Wei-Peng Yong²³, YU Jiren²⁴, ZHANG Jun^1b, Asian Gastric Cancer NIPS Treatment Collaborative Group^1b, Shanghai Anticancer Association, Committee of Peritoneal Tumor^1b

1a. Department of General Surgery, Shanghai Institute of Digestive Surgery, Shanghai Key Laboratory of Gastric Neoplasms, b. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2. Department of Gastrointestinal Surgery, Clinical Research Center, Jichi Medical University, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan
3. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea, Seoul National University College of Medicine, Seoul, Korea
4. Department of Surgery, National University Hospital, National University of Singapore, Singapore
5. Department of General Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
6. Department of General Surgery, Peking University International Hospital, Beijing 102206, China
7. Zhejiang Provincial Research Center for Upper Gastrointestinal Tract Cancer, Zhejiang Cancer Hospital, Zhejiang Hangzhou 310022, China
8. Department of Gastrointestinal Surgery, Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Sichuan Chengdu 610041, China
9. Department of Surgery, Faculty of Medicine, Kindai University, Higashiosaka, Osaka, Japan
10. Department of Chemotherapy, The University of Tokyo Hospital, Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan
11. Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
12. Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
13. Department of Gastroenterological Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
14. Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
15. Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
16. Department of Gastroenterology & Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Zhejiang Hangzhou 310014, China
17. Department of General Surgery, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China
18. Division of Foregut Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
19. Department of General Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Hangzhou 310009, China
20. Department of General Surgery, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Nanjing 210029, China
21. Department of Surgery, Division of Clinical Oncology, Jichi Medical University, Shimotsuke, Tochigi, Japan
22. Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan
23. Department of Haematology-Oncology, National University Cancer Institute, Singapore
24. Department of Gastrointestinal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Hangzhou 310003, China

Received:2025-07-10 Online:2025-07-25 Published:2025-10-23
Contact: ZHU Zhenggang E-mail:zzg1954@hotmail.com

Abstract

Abstract:

Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Key words: Gastric cancer, Peritoneal metastasis(PM), Normothermic intraperitoneal chemotherapy, Intraperitoneal and systemic chemotherapy, Conversion surgery, Consensus

CLC Number:

R735.2

ZHU Zhenggang, Joji Kitayama, Hyung-Ho Kim, Jimmy Bok-Yan So, CAO Hui, CHEN Lin, CHENG Xiangdong, HU Jiankun, Motohiro Imano, Hironori Ishigami, Ye Seob Jee, Jong-Han Kim, Yasuhiro Kodera, LIANG Han, LIU Xiaowen, LU Sheng, MOU Yiping, NIE Mingming, Won Jun Seo, WANG Yanong, WU Dan, XU Zekuan, Hironori Yamaguchi, YAN Chao, YANG Zhongyin, YIN Kai, Yutaka Yonemura, Wei-Peng Yong, YU Jiren, ZHANG Jun, Asian Gastric Cancer NIPS Treatment Collaborative Group, Shanghai Anticancer Association, Committee of Peritoneal Tumor. Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis[J]. Journal of Surgery Concepts & Practice, 2025, 30(04): 277-294.

Figures/Tables 3

Tab 1

Fig1

Tab 2

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证据级别
A（强）	效果的期望值有很强的可靠性
B（中）	效果的期望值有中等强度的可靠性
C（弱）	效果的期望值可靠性有限
D（很弱）	效果的期望值几乎无可靠性

腹腔内治疗	全身治疗
紫杉醇20 mg/m²，第1、8天	静脉紫杉醇50 mg/m²，第1、8天+口服S-1 40 mg/m² ，每天2次，第1~14天[PS（紫杉醇＋S-1）]方案^[10,85]
紫杉醇20 mg/m²，第1、8、22天	静脉顺铂60 mg/m²，第8天+口服S-1 40 mg/m²，每天2次，第1~14天（SP方案）^[52]
紫杉醇40~80 mg/m²，第1、8天	静脉奥沙利铂100 mg/m²，第1天+口服S-1 40 mg/m²，每天2次，第1~14天（SOX方案）^[65]
紫杉醇40 mg/m²，第1、8天	静脉奥沙利铂100 mg/m²，第1天+口服卡培他滨1 000 mg/m²，每天2次，第1~14天（CAPEOX方案）^[96]
紫杉醇60 mg/m²，第1天	静脉奥沙利铂100 mg/m²，第1天+静脉亚叶酸钙100 mg/m²，第1天+静脉氟尿嘧啶100 mg/m²，第1天（FOLFOX方案）^[54]
紫杉醇80 mg/m²，第1天	静脉奥沙利铂100 mg/m²，第1天+口服S-1 40 mg/m²，每天2次，第1~14天（SOX方案）^[97]
紫杉醇80 mg/m²，第1、8天	静脉紫杉醇50 mg/m²，第1、8天+口服S-1 40 mg/m²，每天2次，第1~14天（PS方案）^[92]
多西他赛40~60 mg/m²，第1、8天	口服S-1 40 mg/m²，每天2次，第1~14天^[93]
多西他赛35~50 mg/m²，第1、15天	口服S-1 40 mg/m²，每天2次，第1~14天^[98]
顺铂30 mg/m²，第1天+多西他赛30 mg/m²，第1天	口服S-1 30 mg/m²，每天2次，第1~14天^[99]

Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis

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