Hyperthermic intraperitoneal chemotherapy for patients with gastric cancer based on laboratory tests is safe: a single Chinese center analysis

Abstract

Purpose: This study evaluated the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer diagnosed from laboratory tests. Methods: The clinical and pathological data of 63 patients with gastric cancer who underwent HIPEC in 2017–2021 were prospectively recorded. Fifty-five patients underwent cytoreductive surgery + HIPEC, and eight patients received HIPEC alone. The factors associated with HIPEC safety and efficacy were analyzed. The primary endpoint was overall survival.Results: The average patient age was 54.84 years and 68.3% of patients were male. Moreover, 79.4% of patients had a peritoneal carcinoma index (PCI) score of ≤7 and 61.9% had a completeness of cytoreduction score of 0. Because of peritoneal metastasis, 29 patients (46.03%) were classified as stage IV. Laboratory tests showed no differences in pre-HIPEC blood test results compared to post-HIPEC results after removing the effects of surgery. HIPEC treatment did not cause obvious liver or kidney damage. Serum calcium levels decreased significantly after HIPEC (P=0.0018). The Karnofsky performance status (KPS) score correlated with the patient’s physical function and improved after HIPEC (P=0.0045). In coagulation tests, FDP (P<0.0001) and D-dimer (P<0.0001) levels increased significantly and CA242 (P=0.0159), CA724 (P<0.0001), and CEA (P<0.0014) levels decreased significantly after HIPEC. Completeness of cytoreduction score was an independent prognostic factor. HIPEC did not show a survival benefit in patients with gastric cancer (P=0.5505).Conclusion: HIPEC is a safe treatment for patients with gastric cancer with peritoneal metastasis based on the laboratory tests. Its efficacy in terms of overall survival requires confirmation.