curative gastrectomy for gastric cancer study (EXPEL): An - PowerPoint PPT Presentation

Extensive peritoneal lavage after curative gastrectomy for gastric cancer study (EXPEL): An international multicenter randomized controlled Trial JB So, HK Yang, JF Ji, M Terashima, GX Li, SU Han, BC Tai on behalf of EXPEL Study group Jimmy B.Y. So

Methods: Study Design • Prospective, open-labelled, investigator-initiated, phase 3 randomised controlled trial Lavage Arm Follow-up: 10 Liters of 3 monthly for 1 st 2 years normal saline 6 monthly for 3 rd year Primary endpoint Eligibility Criteria • Gastric cancer: Overall survival R cT3/4, N0-2, M0 Curative surgery Secondary endpoints • 1. Disease free survival Standard arm 2. Peritoneal recurrence ≤2 Liters of normal saline Jimmy B.Y. So

Results: 800 patients randomised Consort Diagram Lavage (n=398) Standard (n=402) 2 exclusions: 1 exclusion : • No follow up information • No follow up information 401 analysed 396 analysed Non-compliance Non-compliance • 1 received lavage • 2 did not receive lavage • 55 lost to follow-up • 44 lost to follow-up - <= 3 months (n=1) <= 3 months (n=1) - - 6 to 12 months (n=4) 6 to 12 months (n=6) - - > 12 months (n=39) > 12 months (n=48) - Jimmy B.Y. So

Primary endpoint- Overall Survival

Conclusion • Extensive lavage with saline did not reduce risk of peritoneal recurrence nor improve survival after gastric cancer surgery • It may increase risk of postoperative complications • We do not recommend this treatment for gastric cancer patients Jimmy B.Y. So