Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy

Background: In gastric cancer (GC), the dissemination of neoplastic cells (NCs) in the peritoneal cavity is related to disease progression and poor prognosis. Elimination of NC through chemotherapy is needed to achieve better outcomes before conversion surgery. Objectives: The objective of this stud...

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Main Authors: Odilon de Souza Filho, Reinaldo Rondinelli, Antônio Carlos Acetta, Sérgio Bertolace, Alexandre Palladino, Cristiano Duque Guedes, Claudia Cristine Rocha Vieira, Luis Claudio Santos Thuler, Claudia Diniz, Everton Cruz dos Santos, Eliana Abdelhay
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359251337480
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author Odilon de Souza Filho
Reinaldo Rondinelli
Antônio Carlos Acetta
Sérgio Bertolace
Alexandre Palladino
Cristiano Duque Guedes
Claudia Cristine Rocha Vieira
Luis Claudio Santos Thuler
Claudia Diniz
Everton Cruz dos Santos
Eliana Abdelhay
author_facet Odilon de Souza Filho
Reinaldo Rondinelli
Antônio Carlos Acetta
Sérgio Bertolace
Alexandre Palladino
Cristiano Duque Guedes
Claudia Cristine Rocha Vieira
Luis Claudio Santos Thuler
Claudia Diniz
Everton Cruz dos Santos
Eliana Abdelhay
author_sort Odilon de Souza Filho
collection DOAJ
description Background: In gastric cancer (GC), the dissemination of neoplastic cells (NCs) in the peritoneal cavity is related to disease progression and poor prognosis. Elimination of NC through chemotherapy is needed to achieve better outcomes before conversion surgery. Objectives: The objective of this study was to evaluate the impact of NC CD44+/CD326+ levels through flow cytometry (FC) on peritoneal lavage (PL) fluid as a response indicator for conversion surgery. Methods: Patients with GC and NCs in the peritoneal cavity with or without peritoneal carcinomatosis (PC) and ascites were evaluated via minimally invasive staging. The PLs of patients were analyzed by FC to quantify NCs. All patients were treated with repeated intraperitoneal perfusion normothermic chemotherapy (RIPPENC). Patients who had negative NCs or reduced NCs were referred for conversion surgery. Results: Thirty patients were enrolled in this study and divided into three groups. In the first group, 20 patients with positive cytology (C+) and/or PC with a PC index (PCI) ⩽6 were treated with RIPPENC. Otherwise, six patients with C+ and PC with a PCI >7 and four patients with C+, ascites, and a PCI ranging from 15 to 22 were treated with palliative RIPPENC. The percentage of CD44+/CD326+ cells was correlated with the number of RIPPENC cycles and resections. The median follow-up time was 14.8 months. The overall median survival since the first RIPPENC was 14.6 months among those who did not undergo resection and 22.6 months among those who underwent resection ( p  = 0.001). Moreover, we observed a correlation between the percentage of CD44+/CD326+ cells in the PL region and patient survival. Conclusion: The use of FC to identify PL CD44+/CD326+ cell levels may be an important innovative biomarker for determining the presence of NCs, directly affecting the success of RIPPENC for conversion surgery.
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spelling doaj-art-a94cb9b8a4c04f3391b6c901d68e63762025-08-20T01:49:01ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-05-011710.1177/17588359251337480Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapyOdilon de Souza FilhoReinaldo RondinelliAntônio Carlos AcettaSérgio BertolaceAlexandre PalladinoCristiano Duque GuedesClaudia Cristine Rocha VieiraLuis Claudio Santos ThulerClaudia DinizEverton Cruz dos SantosEliana AbdelhayBackground: In gastric cancer (GC), the dissemination of neoplastic cells (NCs) in the peritoneal cavity is related to disease progression and poor prognosis. Elimination of NC through chemotherapy is needed to achieve better outcomes before conversion surgery. Objectives: The objective of this study was to evaluate the impact of NC CD44+/CD326+ levels through flow cytometry (FC) on peritoneal lavage (PL) fluid as a response indicator for conversion surgery. Methods: Patients with GC and NCs in the peritoneal cavity with or without peritoneal carcinomatosis (PC) and ascites were evaluated via minimally invasive staging. The PLs of patients were analyzed by FC to quantify NCs. All patients were treated with repeated intraperitoneal perfusion normothermic chemotherapy (RIPPENC). Patients who had negative NCs or reduced NCs were referred for conversion surgery. Results: Thirty patients were enrolled in this study and divided into three groups. In the first group, 20 patients with positive cytology (C+) and/or PC with a PC index (PCI) ⩽6 were treated with RIPPENC. Otherwise, six patients with C+ and PC with a PCI >7 and four patients with C+, ascites, and a PCI ranging from 15 to 22 were treated with palliative RIPPENC. The percentage of CD44+/CD326+ cells was correlated with the number of RIPPENC cycles and resections. The median follow-up time was 14.8 months. The overall median survival since the first RIPPENC was 14.6 months among those who did not undergo resection and 22.6 months among those who underwent resection ( p  = 0.001). Moreover, we observed a correlation between the percentage of CD44+/CD326+ cells in the PL region and patient survival. Conclusion: The use of FC to identify PL CD44+/CD326+ cell levels may be an important innovative biomarker for determining the presence of NCs, directly affecting the success of RIPPENC for conversion surgery.https://doi.org/10.1177/17588359251337480
spellingShingle Odilon de Souza Filho
Reinaldo Rondinelli
Antônio Carlos Acetta
Sérgio Bertolace
Alexandre Palladino
Cristiano Duque Guedes
Claudia Cristine Rocha Vieira
Luis Claudio Santos Thuler
Claudia Diniz
Everton Cruz dos Santos
Eliana Abdelhay
Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
Therapeutic Advances in Medical Oncology
title Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
title_full Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
title_fullStr Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
title_full_unstemmed Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
title_short Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
title_sort impact of cd44 326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy
url https://doi.org/10.1177/17588359251337480
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