Intraperitoneal chemotherapy in advanced gastric cancer. Meta-analysis of randomized trials

Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for the prevention and control of peritoneal metastasis in patients with gastrointestinal malignancies: a systematic review of randomized controlled trials

“…Thus preventing the recurrence of gastric cancer can possibly help in improving the survival of the patients. Compared to other treatment modalities for patients with gastric cancer, studies have reported that HIPEC has a positive outcome on improving overall survival (Yan et al, 2007[ 35 ]; Liang, 2016[ 16 ]; Coccolini et al, 2014[ 5 ]). However, studies in the literature lack in reporting the effectiveness of prophylactic HIPEC in preventing recurrence of peritoneal metastasis in patients with gastric cancer.…”

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

“…The principal aim of the multimodal treatment in AGC is to prevent and/or to treat efficiently PC. Some cohort studies demonstrated its efficacy in advanced AGC with or without PC (14). Many randomized controlled trials (RCT) confirmed the efficacy of IPC in treating AGC.…”

“…In this field in fact the majority still looks diffidently to this combination of systems and times to deliver chemotherapy and more in general to the intraperitoneal administration of chemotherapy. This diffidence surprisingly exists despite of AGC is the only disease in which exist level 1 evidences of the effectiveness of IPC (14). Few previous studies reported promising results about the use of IPC as prophylaxis and treatment of PC by comparing groups of patients affected by AGC with and without PC.…”

“…This clearly demonstrated as serosal invasion with free cancer cells are comparable in terms of OS to PC. Recent data form a meta-analysis of randomized controlled trials (RCT) demonstrated the benefit to introduce intra-peritoneal chemotherapy (IPC) as preventive or prophylactic treatment of AGC without PC (14). Moreover the necessity to reach a complete cytoreduction in order to increase the survival has been demonstrated by another recent meta-analysis (15).…”

Neoadjuvant intraperitoneal chemotherapy for advanced stage gastric cancer (Review)

“…Therefore, minimally invasive surgery in association with neoadjuvant HIPEC alone (in the absence of debulking surgery) appears to maximize the oncological benefits and to minimize the risks of perioperative morbidity. In addition, other authors have also examined the possibility of performing neoadjuvant HIPEC as prophylaxis of peritoneal carcinomatosis in patients with positive cytology; in this respect, in cases presenting serosal invasion, peritoneal cytology should be retrieved and whenever malignant cells are encountered, neoadjuvant HIPEC followed by interval radical gastrectomy should be the option of choice (17,18). However, an interesting difference of opinion should be underlined between Eastern and Western countries; while in Asian trial studies published thus far the effectiveness of HIPEC was demonstrated in patients with serosal invasion as well as in those with peritoneal carcinomatosis, in Western countries it appears that the method proved to be particularly efficient only in cases with serosal invasion.…”