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PTH-87 Current treatment modalities and median survival for patients with gastric cancer and isolated peritoneal metastasis

Introduction Gastric cancer with peritoneal metastases carries a median survival of only 3-7 months without treatment, and no treatment modality in standard practice appears to improve survival beyond a few months. In order to measure the efficacy of emerging modes of treatment, it is essential to describe the treatments patients currently receive and the impact of these on survival – data for which is poorly described in the literature and lacking in the UK setting. Methods This was a single hospital-based retrospective cohort study which included 50 patients who received a diagnosis of gastric adenocarcinoma with isolated peritoneal disease between the dates 21 March 2012 to 14 January 2020 at a tertiary referral centre. We calculated median survival time for all patients and also by treatment modality. Results The mean age of patients was 71 years (range 44-90 years). Overall, 26 patients (52%) received systemic chemotherapy, three (6%) gastrectomy, six (12%) endoscopic stenting and 15 (30%) best supportive care. Overall median survival was 6.6 months (IQR 2.4-19.3). At a mean of 16.4 months follow-up, 43 patients (86%) had died. Median survival by treatment modality was as follows: supportive care (2.4 months, IQR 1.2-5.1), endoscopic stent (5.7 months, IQR 3.671.2), systemic chemotherapy (11.2 months, IQR 3.7-21.5), and palliative gastrectomy (15.1 months, IQR 6.6 to 55.9). Conclusions Our results confirm the poor prognosis of gastric cancer patients with isolated peritoneal disease with available treatments only extending survival by a maximum of 4 to 8 months, highlighting the desperate need for new treatment modalities.