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BackgroundGastric cancer (GC) is the fifth most common malignancy in the world, with an incidence of approximately 1 million new patients worldwide in 2022 1 .Due to its aggressive behaviour and the late appearance of symptoms, such as bleeding, loss of appetite, weight loss, and abdominal pain, most patients have locally advanced and/or metastatic disease at first presentation.Especially in patients with diffuse-type GC, the peritoneum is the most common site of metastatic spread.At least 40% of patients with GC are confronted with peritoneal metastases (PM) during their disease, leaving them with a miserable prognosis of a median overall survival of 7-9 months.Following European Society for Medical Oncology ('ESMO') and National Comprehensive Cancer Network ('NCCN') guidelines, the treatment of choice for patients with metastatic GC is two-agent systemic chemotherapy, preferably a platinum/fluoropyrimidine doublet, in combination with targeted therapy or immunotherapy considering human epidermal growth factor receptor 2 (HER2) and programmed death-ligand 1 (PD-L1) status 2,3 .
Brandl et al. (Mon,) studied this question.