S-1 and the treatment of gastric cancer with peritoneal dissemination

Izuishi,Kunihiko; Haba,Reiji; Kushida,Yoshio; Kadota,Kyuichi; Takebayashi,Ryusuke; Sano,Takanori; Usuki,Hisashi; Hossain,Mohammad  Akram; Mori,Hirohito; Masaki,Tsutomu; Suzuki,Yasuyuki

doi:10.3892/etm.2011.290

S-1 and the treatment of gastric cancer with peritoneal dissemination

Authors:
- Kunihiko Izuishi
- Reiji Haba
- Yoshio Kushida
- Kyuichi Kadota
- Ryusuke Takebayashi
- Takanori Sano
- Hisashi Usuki
- Mohammad Akram Hossain
- Hirohito Mori
- Tsutomu Masaki
- Yasuyuki Suzuki
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Affiliations: Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, Takamatsu, Kagawa 760-0018, Japan, Department of Diagnostic Pathology, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, Takamatsu, Kagawa 760-0018, Japan, Department of Cell Physiology, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, Takamatsu, Kagawa 760-0018, Japan, Department of Internal Medicine, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, Takamatsu, Kagawa 760-0018, Japan
Published online on: June 20, 2011 https://doi.org/10.3892/etm.2011.290
Pages: 985-990

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Abstract

Peritoneal dissemination is the most common metastatic pattern of gastric cancer. We frequently face the necessity for gastrectomy in the event of gastric stenosis or gastric bleeding. However, the indication for palliative gastrectomy and the effectiveness of palliative chemotherapy are not clear. We retrospectively evaluated the prognostic factors after palliative gastrectomy in 121 gastric cancer patients with peritoneal dissemination. The expression of orotate phosphoribosyl transferase (OPRT) was examined immunohistochemically. The median survival time of all patients after palliative gastrectomy was 8.8 months. In the multivariate analyses, we adjusted the data of 82 patients without liver metastases for the background of 5-fluouracil (5-FU)-based chemotherapy regimen. The analysis revealed that the degree of peritoneal dissemination (multiple vs. a few metastases or cytology-positive; P=0.01) and chemotherapy (S-1 vs. other 5-FU; P=0.01) were independent predictors of survival. Particularly, S-1 treatment was associated with a more favorable prognosis of the patients with high levels of OPRT expression compared to that of the patients with low expression. Patients with peritoneal dissemination are considered as terminal and inoperable. However, S-1 treatment may improve the survival after palliative gastrectomy in patients selected according to the degree of peritoneal dissemination and high OPRT expression.

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1.	Hartgrink HH, Putter H, Klein Kranenbarg E, Bonenkamp JJ and van de Velde CJ: Value of palliative resection in gastric cancer. Br J Surg. 89:1438–1443. 2002. View Article : Google Scholar : PubMed/NCBI
2.	Ishizone S, Maruta F, Saito H, Koide N, Sugiyama A, Nakayama J and Miyagawa S: Efficacy of S-1 for patients with peritoneal metastasis of gastric cancer. Chemotherapy. 52:301–307. 2006. View Article : Google Scholar : PubMed/NCBI
3.	Sadeghi B, Arvieux C, Glehen O, et al: Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study. Cancer. 88:358–363. 2000. View Article : Google Scholar : PubMed/NCBI
4.	Kodera Y, Yamamura Y, Shimizu Y, et al: Peritoneal washing cytology: prognostic value of positive findings in patients with gastric carcinoma undergoing a potentially curative resection. J Surg Oncol. 72:60–64. 1999. View Article : Google Scholar
5.	Bando E, Yonemura Y, Takeshita Y, et al: Intraoperative lavage for cytological examination in 1,297 patients with gastric carcinoma. Am J Surg. 178:256–262. 1999. View Article : Google Scholar : PubMed/NCBI
6.	Sakuramoto S, Sasako M, Yamaguchi T, et al: Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 357:1810–1820. 2007. View Article : Google Scholar : PubMed/NCBI
7.	Kubota T: The role of S-1 in the treatment of gastric cancer. Br J Cancer. 98:1301–1304. 2008. View Article : Google Scholar : PubMed/NCBI
8.	Koizumi W, Narahara H, Hara T, et al: S-l plus cisplatin versus S-l alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 9:215–221. 2008. View Article : Google Scholar : PubMed/NCBI
9.	Kobayashi O, Konishi K, Kanari M, et al: Unusual survival for more than 2 years with peritoneal metastases of gastric cancer. Gastric Cancer. 5:47–50. 2002.PubMed/NCBI
10.	Kai K, Kitajima Y, Hiraki M, et al: Quantitative double-fluorescence immunohistochemistry (qDFIHC), a novel technology to assess protein expression: a pilot study analyzing 5-FU sensitive markers thymidylate synthase, dihydropyrimidine dehydrogenase and orotate phosphoribosyl transferases in gastric cancer tissue specimens. Cancer Lett. 258:45–54. 2007.
11.	Ishikawa M, Miyauchi T and Kashiwagi Y: Clinical implications of thymidylate synthetase, dihydropyrimidine dehydrogenase and orotate phosphoribosyl transferase activity levels in colorectal carcinoma following radical resection and administration of adjuvant 5-FU chemotherapy. BMC Cancer. 8:1882008. View Article : Google Scholar
12.	Tokunaga Y, Sasaki H and Saito T: Clinical role of orotate phosphoribosyl transferase and dihydropyrimidine dehydrogenase in colorectal cancer treated with postoperative fluoropyrimidine. Surgery. 141:346–353. 2007. View Article : Google Scholar
13.	Japanese Gastric Cancer Association: Japanese Classification of Gastric Carcinoma, 2nd English edition. Gastric Cancer. 1:10–24. 1998. View Article : Google Scholar : PubMed/NCBI
14.	Bonenkamp JJ, Songun I, Hermans J and van de Velde CJ: Prognostic value of positive cytology findings from abdominal washings in patients with gastric cancer. Br J Surg. 83:672–674. 1996. View Article : Google Scholar : PubMed/NCBI
15.	Sakata Y, Ohtsu A, Horikoshi N, Sugimachi K, Mitachi Y and Taguchi T: Late phase II study of novel oral fluoropyrimidine anticancer drug S-1 (1 M tegafur-0.4 M gimestat-1 M otastat potassium) in advanced gastric cancer patients. Eur J Cancer. 34:1715–1720. 1998. View Article : Google Scholar : PubMed/NCBI
16.	Koizumi W, Kurihara M, Nakano S and Hasegawa K: Phase II study of S-1, a novel oral derivative of 5-fluorouracil, in advanced gastric cancer. Oncology. 58:191–197. 2000. View Article : Google Scholar : PubMed/NCBI
17.	Esquivel J, Vidal-Jove J, Steves MA and Sugarbaker PH: Morbidity and mortality of cytoreductive surgery and intraperitoneal chemotherapy. Surgery. 113:631–636. 1993.PubMed/NCBI
18.	Jacquet P and Sugarbaker PH: Peritoneal-plasma barrier. Cancer Treat Res. 82:53–63. 1996. View Article : Google Scholar
19.	Mori T, Fujiwara Y, Yano M, Tamura S, Yasuda T, Takiguchi S and Monden M: Experimental study to evaluate the usefulness of S-1 in a model of peritoneal dissemination of gastric cancer. Gastric Cancer. 6(Suppl 1): 13–18. 2003. View Article : Google Scholar : PubMed/NCBI
20.	Yamagata S, Nakata B and Hirakawa K: Dihydropyrimidine dehydrogenase inhibitory fluoropyrimidine S-1 may be effective against peritoneal dissemination in gastric cancer. Oncol Rep. 12:973–978. 2004.
21.	Ichikawa W and Sasaki Y: Challenges in predicting the clinical outcome in S-1-based chemotherapy for gastric cancer patients. Int J Clin Oncol. 13:206–211. 2008. View Article : Google Scholar : PubMed/NCBI
22.	Kuramochi H, Hayashi K, Uchida K, et al: 5-Fluorouracil-related gene expression levels in primary colorectal cancer and corresponding liver metastasis. Int J Cancer. 119:522–526. 2006. View Article : Google Scholar : PubMed/NCBI
23.	Sarela AI, Miner TJ, Karpeh MS, Coit DG, Jaques DP and Brennan MF: Clinical outcomes with laparoscopic stage M1, unresected gastric adenocarcinoma. Ann Surg. 243:189–195. 2006. View Article : Google Scholar : PubMed/NCBI
24.	Saito H, Yamada Y, Tsujitani S and Ikeguchi M: Clinicopathologic characteristics of gastric cancer patients who underwent noncurative gastrectomy with long-term survival. Langenbecks Arch Surg. 394:99–103. 2009. View Article : Google Scholar : PubMed/NCBI
25.	Sakamoto E, Nagase H, Kobunai T, Oie S and Oka T, Fukushima M and Oka T: Orotate phosphoribosyltransferase expression level in tumors is a potential determinant of the efficacy of 5-fluorouracil. Biochem Biophys Res Commum. 363:216–222. 2007. View Article : Google Scholar