2018, Número 3
Papel de la cirugía citorreductora y la quimioterapia intraperitoneal hipertérmica en el tratamiento del cáncer gástrico
López-Basave HN, Quiroz-Sandoval OA, Padilla-Rosciano AE, León-Takahashi AM, Miranda-Devora G, Arrollo-Monroy A
Idioma: Ingles.
Referencias bibliográficas: 31
Paginas: 277-284
Archivo PDF: 177.61 Kb.
RESUMEN
Los pacientes con carcinomatosis peritoneal (CP) de origen gástrico tienen un mal pronóstico de vida, con una supervivencia
media de 1 a 3 meses. La quimioterapia sistémica ha mejorado la supervivencia de los pacientes con cáncer gástrico metastásico
a los 7-10 meses. Sin embargo, este beneficio no se ha podido reproducir en los pacientes con CP. En cuanto a lo
relacionado con la literatura actual para el uso de HIPEC (
hyperthermic intraperitoneal chemotherapy) en la CP de origen
gástrico, existe una variación significativa en la selección de pacientes, la intención de tratamiento (paliativo frente a intento
de tratamiento curativo), la técnica quirúrgica, el agente quimioterapéutico intraperitoneal utilizado y la quimioterapia sistémica
adyuvante administrada. Desde la perspectiva de la selección de pacientes para citorreducción y tratamiento con HIPEC,
los pacientes con CP extensa no son candidatos. Además, lesiones irresecables por su localización harían al paciente un
pobre candidato para citorreducción y tratamiento con HIPEC. De manera óptima, aquellos pacientes con citología peritoneal
positiva en ausencia de CP son quienes más podrían beneficiarse. Sin embargo, el papel de la cirugía citorreductora y del
tratamiento con HIPEC en los pacientes con CP de origen gástrico aún no ha sido esclarecido.
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