{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:39:45Z","timestamp":1793018385441,"version":"4.5.0"},"reference-count":41,"publisher":"Harborside Press, LLC","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Palliative systemic treatment is currently standard of care for metastatic gastric cancer. However, patients with peritoneal metastases of gastric origin are often underrepresented in clinical studies due to unmeasurable radiologic disease. This study describes the systemic treatment strategies and outcomes in patients with peritoneal metastases in a nationwide real-world setting. <jats:bold>Methods:<\/jats:bold> Patients with gastric adenocarcinoma and synchronous peritoneal metastases (with or without other metastases) diagnosed in the Netherlands between 2015 and 2020 were identified from the nationwide Netherlands Cancer Registry. Median overall survival (OS) and time-to-treatment failure were determined and multivariable Cox regression analyses were used to compare treatment groups, corrected for relevant tumor and patient characteristics.<jats:bold> Results:<\/jats:bold> In total, 1,972 patients were included, of whom 842 (43%) were treated with palliative systemic therapy. The majority received capecitabine + oxaliplatin (CAPOX; 44%), followed by fluorouracil\/leucovorin\/oxaliplatin (FOLFOX; 19%), and epirubicin + capecitabine + oxaliplatin (EOX; 8%). Of the 99 (45%) patients who received second-line systemic treatment, ramucirumab + paclitaxel were administered most frequently (63%). After adjustment for sex, age, comorbidities, performance status, tumor location, Lauren classification, and the presence of metastases outside of the peritoneum, patients treated with a triplet containing docetaxel and those treated with a regimen containing trastuzumab had a significantly longer OS compared with patients treated with a doublet containing a fluoropyrimidine derivate + oxaliplatin (hazard ratio [HR], 0.69; 95% CI, 0.52\u20130.91, and HR, 0.68; 95% CI, 0.51\u20130.91, respectively). Monotherapy was associated with a shorter OS (HR, 2.08, 95% CI, 1.53\u20132.83). <jats:bold>Conclusions:<\/jats:bold> There is substantial heterogeneity in systemic treatment choices in patients with gastric cancer and peritoneal metastases in the Netherlands. In this study, patients treated with triplets containing docetaxel and with trastuzumab-containing regimens survived longer than patients who received doublet therapy. Despite this, median OS for all treatment groups remained below one year.<\/jats:p>","DOI":"10.6004\/jnccn.2024.7013","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T18:10:07Z","timestamp":1722276607000},"page":"405-412","source":"Crossref","is-referenced-by-count":11,"title":["Systemic Treatment Strategies and Outcomes of Patients With Synchronous Peritoneal Metastases of Gastric Origin: A Nationwide Population-Based Study"],"prefix":"10.6004","volume":"22","author":[{"given":"Niels A.D.","family":"Guchelaar","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo J.","family":"Noordman","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion W.","family":"Welten","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Catharina Cancer Institute, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron T.","family":"van Santen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha J.","family":"de Neijs","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn L.W.","family":"Koolen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"},{"name":"Department of Pharmacy, Erasmus Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob H.A.","family":"Verhoeven","sequence":"additional","affiliation":[{"name":"Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"},{"name":"Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Oomen-de Hoop","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter C.","family":"van der Sluis","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd M.","family":"Lagarde","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke W.M.","family":"van Laarhoven","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands"},{"name":"Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignace H.J.T.","family":"de Hingh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Cancer Institute, Eindhoven, the Netherlands"},{"name":"Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert-Jan","family":"Creemers","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Catharina Cancer Institute, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Mostert","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas P.L.","family":"Wijnhoven","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron H.J.","family":"Mathijssen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Ann Oncol","first-page":"3056","article-title":"No improvement in median survival for patients with metastatic gastric cancer despite increased use of chemotherapy","volume":"24","author":"Bernards N","year":"2013","unstructured":"Bernards N, Creemers GJ, Nieuwenhuijzen GA,  No improvement in median survival for patients with metastatic gastric cancer despite increased use of chemotherapy. 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