{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:13:30Z","timestamp":1790673210855,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T00:00:00Z","timestamp":1404518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A prospective randomized trial was conducted to compare the impact of systemic chemotherapy versus multi\u2010modality therapy (complete cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and systemic chemotherapy) on overall survival (OS) in patients with gastric carcinomatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with measurable metastatic gastric adenocarcinoma involving the peritoneum, and resectable to \u201cno evidence of disease\u201d were randomized to gastrectomy, metastasectomy, HIPEC, and systemic FOLFOXIRI (GYMS arm) or FOLFOXIRI alone (SA arm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen patients were enrolled (16 evaluable); 7 of 9 patients in the multi\u2010modality GYMS arm achieved complete cytoreduction (CCR0). Median OS was 11.3 months in the GYMS arm and 4.3 months in the SA arm. Four patients in the GYMS arm survived &gt;12 months, 2 patients close to 2 years at last follow\u2010up, and 1 patient more than 4 years, with 2 of these patients still alive. No patient in the SA arm lived beyond 11 months. All patients surviving beyond 12 months in the surgery arm achieved complete cytoreduction and had an initial Peritoneal Cancer Index (PCI) of \u226415.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maximal cytoreductive surgery combined with regional (HIPEC) and systemic chemotherapy in selected patients with gastric carcinomatosis and limited disease burden can achieve prolonged survival. <jats:italic>J. Surg. Oncol. 2014 110:275\u2013284<\/jats:italic>. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23633","type":"journal-article","created":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T14:57:11Z","timestamp":1404572231000},"page":"275-284","source":"Crossref","is-referenced-by-count":188,"title":["Impact of maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin: Results of the GYMSSA trial"],"prefix":"10.1002","volume":"110","author":[{"given":"Udo","family":"Rudloff","sequence":"first","affiliation":[{"name":"Surgery Branch National Cancer Institute National Institutes of Health Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell C.","family":"Langan","sequence":"additional","affiliation":[{"name":"Surgery Branch National Cancer Institute National Institutes of Health Bethesda Maryland"},{"name":"Georgetown 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