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

Catena, Fausto; Celotti, Andrea; Ceresoli, Marco; Montori, Giulia; Marini, Michele; Ansaloni, Luca

doi:10.21037/jgo.2016.06.05

Cited by 22 publications

(13 citation statements)

References 30 publications

(37 reference statements)

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“…The aim of this study was to investigate the feasibility of a more comprehensive and relatively aggressive treatment regimen in the management of locally advanced GC. The efficacy of HIPEC as a prophylaxis against PC primary to disease progression or secondary to surgical trauma has been investigated and supported in previous literature [14,[19][20][21][22] . The role of chemotherapy in the pre-surgical setting with the main goals of tumor downsizing and down-staging has also been thoroughly investigated and acclaimed over the past few decades [27][28][29][30] .…”

Section: Discussionmentioning

confidence: 80%

“…In a study by Cui et al, the combination of NAC with HIPEC for the treatment of AGC was well tolerated and exhibited improved compliance and efficiency with survival benefit [18] . In a study by Coccolini et al, prophylactic HIPEC associated to NAC increased the DFS and OS in patients with AGC without carcinomatosis [19] . Nevertheless, there have been more reports about the combination of NAC followed by HIPEC improving the survival rates in ovarian cancer [20][21] .…”

Section: Introductionmentioning

confidence: 93%

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Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

Beeharry

Liu

et al. 2020

Preprint

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Objective: In this study we have retrospectively evaluated the feasibility and safety of a novel therapeutic regimen for the management of Advanced Gastric Cancer (AGC) at risk for peritoneal carcinomatosis (PC) involving neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (NLHIPEC) and neoadjuvant chemotherapy (NAC).Methods: From December 2017 to June 2018, 7 AGC patients undergoing NLHIPEC + NAC + Surgery+ Intraoperative HIPEC + adjuvant chemotherapy (AC) were included in the study and observed for associated complication and morbidity. AGC patients undergoing other neoadjuvant and prophylactic treatment approaches were retrospectively analyzed and case-matched. Intraoperative and post-operative events, clinical recovery and morbidity were closely monitored till 1 month after the last cycle of chemotherapy.Results: Of a total of 328 AGC patients undergoing curative surgery, 7 other patients undergoing NAC + HIPEC, 7 patients undergoing surgery + HIPEC and 17 patients undergoing NAC were retrospectively included. There was no 30-day post-operative mortality recorded in the 4 groups. In total, 14 events were recorded and 5/14 of the complications were rated as Clavien I; 8/14 patients were classified as Clavien II and 1/14 patient was recorded as Clavien grade IIIa. There was no grade IIIb-V event. The results suggest that the proposed treatment regimen is safe and feasible.Conclusions: This combination of NLHIPEC and NAC in the management of AGC at high risk for peritoneal involvement is feasible, safe, well-tolerated and worth exploring.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 93%

Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

Beeharry

Liu

et al. 2020

Preprint

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“…Data on morbidity were provided in two randomised controlled trials [14,23] and four non-randomised comparative studies [14,17,19,21]. Total numbers for morbidity ranged from 16.7% to 60% after prophylactic HIPEC and from 25% to 42.5% after SA.…”

Section: Resultsmentioning

confidence: 99%

“…Overall survival was reported in one randomised controlled trial [23] and three non-randomised comparative studies [17,20,21], ranging from 32 to 34.6 months in the intervention group and from 22 to 28.2 months in the control group. Although overall survival was higher in the HIPEC group compared to the SA group in all studies, this was significant in only one non-randomised study (Hirose et al, 33 vs. 22 months, p = 0.0142) [17].…”

Section: Resultsmentioning

confidence: 99%

Prophylactic Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer—A Systematic Review

Brenkman

Päeva

Hillegersberg

et al. 2019

JCM

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Survival after potentially curative treatment of gastric cancer remains low, mostly due to peritoneal recurrence. This descriptive review gives an overview of available comparative studies concerning prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with gastric cancer with neither clinically evident metastases nor positive peritoneal cytology who undergo potentially curative gastrectomy. After searching the PubMed, Embase, CDSR, CENTRAL and ASCO meeting library, a total of 11 studies were included comparing surgery plus prophylactic HIPEC versus surgery alone (SA): three randomised controlled trials and eight non-randomised comparative studies, involving 1145 patients. Risk of bias was high in most of the studies. Morbidity after prophylactic HIPEC was 17–60% compared to 25–43% after SA. Overall survival was 32–35 months after prophylactic HIPEC and 22–28 months after SA. The 5-year survival rates were 39–87% after prophylactic HIPEC and 17–61% after SA, which was statistically significant in three studies. Peritoneal recurrence occurred in 7–27% in the HIPEC group, compared to 14–45% after SA. This review tends to demonstrate that prophylactic HIPEC for gastric cancer can be performed safely, may prevent peritoneal recurrence and may prolong survival. However, studies were heterogeneous and outdated, which emphasizes the need for well-designed trials conducted according to current standards.

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“…The use of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming more and more widespread in the treatment of peritoneal carcinomatosis (PC) in multiple types of cancer [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis

Asmar

Bendavides

Moreau

et al. 2020

Preprint

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Background: Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications.Patients and methods: We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups.Results: CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively.Conclusion: CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).

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

Cited by 22 publications

References 30 publications

Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

Prophylactic Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Gastric Cancer—A Systematic Review

Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis

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