Hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant chemotherapy as prophylaxis of peritoneal carcinosis from advanced gastric cancer—Effects on overall and disease free survival

Abstract

Background: The possibility to enlarge criteria for intra-peritoneal chemotherapy (IPC) to all patients at high-risk to develop peritoneal carcinosis (i.e., with serosal invasion) is still discussed. Methods: Retrospective case-control study. Three-groups: advanced-gastric-cancer (AGC) (pT4) without proven carcinosis: prophylactic group (PG), those with PC: treatment group (TG), AGC (pT3-pT4) operated without hyperthermic intraperitoneal chemotherapy (HIPEC), surgery alone group (SG T3, SG T4). Results: Forty four patients. 26 (59.1%) were male. Sixteen (36%) patients underwent 16 HIPEC: 6 (38%) had AGC (pT4) without PC (PG), 10 (62%) had carcinosis (TG), 28 were operated without HIPEC (SG T3,

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in ovarian and gastrointestinal peritoneal carcinomatosis: results from a 7-year experience

“…In the last years an increase interest for PC from GC has been motivated by the frequent peritoneal spread and by the poor prognosis of this disease. The results of present study underline the importance to prevent PC in GC to achieve better outcomes as reported also in recent studies and metaanalysis (13)(14)(15)(16)(17).…”

Overall and disease-free survival in patients treated with CRS + HIPEC with cisplatin and paclitaxel for gastric cancer with peritoneal carcinomatosis

“…The most attractive use of HIPEC in GC would be in an adjuvant setting after a curative surgical resection in patients with a high risk of peritoneal recurrence (prophylactic HIPEC). Randomized trials and meta-analysis were performed to study the results of prophylactic HIPEC in patients with locally advanced GC and reported that HIPEC was associated with a significant improvement in the survival rate and in peritoneal recurrence (1,6,8,(11)(12)(13).…”

Treatment of peritoneal metastases from gastric carcinoma

“…Until now, in Europe, the available data has been limited to retrospective studies of minor groups comprising prophylactic HIPEC with surgical treatment only [49,50].…”