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Advances in Gastric Cancer and Peritoneal Diseases
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Advances in Gastric Cancer and Peritoneal Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 1692

Special Issue Editor

Dr. Shin Saito

E-Mail Website
Guest Editor
Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan
Interests: gastric cancer; peritoneal disease; conversion surgery; intraperitoneal chemotherapy; potential biomarker

Special Issue Information

Dear Colleagues,

Peritoneal disease can be the most frequent type of metastasis and site of recurrence in patients with advanced gastric cancer. This being the case, treatments of peritoneal disease should be the key for the improvement of prognoses for these patients. For years, we have focused on Stage IV gastric cancer with peritoneal disease. The intraperitoneal administration of paclitaxel (IP-PTX) has a great medical advantage in controlling peritoneal lesions and can be combined with various systemic chemotherapies.

Hyperthermic intraperitoneal chemotherapy (HIPEC), combined with cytoreductive surgery, has been tried for patients with PM of GC mainly in Western countries. These aggressive treatments have not resulted in significant survival benefits in GC patients with PM. Since the intraperitoneal administration of anticancer drugs can induce an extremely high concentration of drugs in the peritoneal cavity, intraperitoneal chemotherapy would appear to be a reasonable and promising strategy with which to control peritoneal dissemination.

This Special Issue aims to highlight the current knowledge on gastric cancer and peritoneal diseases and underline possible diagnostic as well as therapeutic repercussions in gastric cancer and peritoneal diseases.

Dr. Shin Saito
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastric cancer
  • peritoneal disease
  • conversion surgery
  • intraperitoneal chemotherapy
  • potential biomarker

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Published Papers (2 papers)

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Research

12 pages, 1658 KiB  
Article
Advances in Intraperitoneal Chemotherapy for Gastric Cancer Patients with Peritoneal Metastases: Current Status of Treatment and Institutional Insights
by Shin Saito, Hironori Yamaguchi, Akira Saito, Yuki Kaneko, Hideyuki Ohzawa, Shinichiro Yokota and Joji Kitayama
J. Clin. Med. 2025, 14(10), 3521; https://doi.org/10.3390/jcm14103521 - 17 May 2025
Viewed by 377
Abstract
Introduction: Peritoneal metastasis (PM) is the most common site of recurrence following curative resection for advanced gastric cancer (GC). Along with disease progression, it can lead to complications such as intestinal obstruction, hydronephrosis, obstructive jaundice, and ascites, significantly impairing the patient’s quality of [...] Read more.
Introduction: Peritoneal metastasis (PM) is the most common site of recurrence following curative resection for advanced gastric cancer (GC). Along with disease progression, it can lead to complications such as intestinal obstruction, hydronephrosis, obstructive jaundice, and ascites, significantly impairing the patient’s quality of life. Therefore, peritoneal metastasis is considered a critical target for treatment. In general, these patients are treated with systemic chemotherapy; however, the therapeutic effect is often limited due to the anticancer agents’ poor penetration into the peritoneal cavity. We aim to identify factors associated with the best overall survival (OS) in GC patients with peritoneal metastasis. Methods: Patients with advanced GC who were diagnosed as having macroscopic PM or positive peritoneal cytology by staging laparoscopy were enrolled. We introduced intraperitoneal Paclitaxel (IP-PTX) combined with S-1 plus oxaliplatin (SOX). Gastrectomy with lymph node dissection was performed as conversion surgery when the PM showed an excellent response. Results: Ninety-six patients received IP-PTX + SOX, with a median of 16 courses. The 1- and 5-year OS rates were 70.2% and 24.5%, respectively, with a mean survival time (MST) of 20.0 months. No chemotherapy-related mortality was observed. Conversion surgery was performed in 44 patients (45.8%), with a 1-year OS rate of 100%. Conclusions: Combination chemotherapy using the IP-PTX + SOX regimen is highly effective and is recommended as induction chemotherapy for patients with PM from GC. Conversion gastrectomy should be considered following an excellent response, particularly in patients with peritoneal cancer index (PCI) scores below 20. Full article
(This article belongs to the Special Issue Advances in Gastric Cancer and Peritoneal Diseases)
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22 pages, 2249 KiB  
Article
Gastric Adenocarcinomas with CDX2 Induction Show Higher Frequency of TP53 and KMT2B Mutations and MYC Amplifications but Similar Survival Compared with Cancers with No CDX2 Induction
by Ioannis A. Voutsadakis
J. Clin. Med. 2024, 13(24), 7635; https://doi.org/10.3390/jcm13247635 - 15 Dec 2024
Cited by 1 | Viewed by 871
Abstract
Background: Gastric cancer is one of the most prevalent gastrointestinal cancers. Mortality is high, and improved treatments are needed. A better understanding of the pathophysiology of the disease and discovery of biomarkers for targeted therapies are paramount for therapeutic progress. CDX2, a [...] Read more.
Background: Gastric cancer is one of the most prevalent gastrointestinal cancers. Mortality is high, and improved treatments are needed. A better understanding of the pathophysiology of the disease and discovery of biomarkers for targeted therapies are paramount for therapeutic progress. CDX2, a transcription factor of hindgut specification, is induced in several gastric cancers, especially with intestinal differentiation, and could be helpful for defining sub-types with particular characteristics. Methods: Gastric cancers with induced CDX2 mRNA expression were identified from the gastric cohort of The Cancer Genome Atlas (TCGA) and were compared with cancers that had no CDX2 mRNA induction. Induced CDX2 mRNA expression was defined as mRNA expression z-score relative to all samples above 0, and non-induced CDX2 mRNA expression was defined as mRNA expression z-score relative to all samples below −1. Results: Patients with gastric cancers with CDX2 mRNA induction were older, had less frequently diffuse histology, and more often had mutations in TP53 and KMT2B and amplifications in MYC. CDX2 induction was correlated with HNF4α induction and was reversely correlated with SOX2. Gastric cancers with CDX2 mRNA induction showed lower PD-L1 expression than cancers with lower CDX2 expression but did not differ in CLDN18 mRNA expression. Progression-free and overall survival of the two groups was also not significantly different. Conclusion: Gastric cancers with CDX2 mRNA induction displayed specific characteristics that differentiate them from cancers with no CDX2 induction and could be of interest for optimizing current and future therapies. Full article
(This article belongs to the Special Issue Advances in Gastric Cancer and Peritoneal Diseases)
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