Prophylactic hyperthermic intraperitoneal chemotherapy may benefit the long-term survival of patients after radical gastric cancer surgery

Abstract

Hyperthermic intraperitoneal chemotherapy (HIPEC) has been proven to improve the survival rate of gastric cancer and reduce peritoneal recurrence. We aimed to evaluate the effectiveness and safety of prophylactic HIPEC after radical gastric cancer surgery in this study. Researchers searched for studies published in PubMed, Embase, Web of science, Scopus, Cochrane, Clinical key databases and Microsoft Academic databases to identify studies that examine the impact of prophylactic HIPEC on the survival, recurrence and adverse events of patients undergoing radical gastric cancer surgery. RevMan 5.3 was used to analyze the results and risk of bias. The PROSERO registration number is CRD42021262016. This meta-analysis included 22 studies with a total of 2097 patients, 12 of which are RCTs. The results showed that the 1-, 3- and 5-year overall survival rate was significantly favorable to HIPEC (OR 5.10, 2.07, 1.96 respectively). Compared with the control group, the overall recurrence rate and peritoneal recurrence rate of the HIPEC group were significantly lower (OR 0.41, 0.24 respectively). Significantly favorable to the control group in terms of renal dysfunction and pulmonary dysfunction complications (OR 2.44, 6.03 respectively). Regarding the causes of death due to postoperative recurrence: liver recurrence, lymph node and local recurrence and peritoneal recurrence, the overall effect is not significantly different (OR 0.81, 1.19, 0.37 respectively). 1-, 3- and 5-year overall survival follow-up may be incremented by the prophylactic HIPEC, and which reduce the overall recurrence rate and peritoneal recurrence rate. HIPEC may have high-risk of pulmonary dysfunction and renal dysfunction complications. No difference has been found in the deaths due to recurrence after surgery.

Resection Combined with Hyperthermic Intra-peritoneal Chemotherapy Prevents Peritoneal Implantation Metastasis of Hepatocellular Carcinoma with Spontaneous Rupture

“…Since 1980, when Spratt et al [29] rst used cytoreduction combined with HIPEC to treat a patient with appendiceal pseudo-mucinous neoplasm, R-HIPEC has been applied to ovarian, gastric, colorectal, and pancreatic cancers, as well as peritoneal metastasis of HCC, all of which have exhibited good e cacy. [12][13][14][15]30] With the deepened understanding of the mechanism of R-HIPEC and the study of ruptured bleeding and peritoneal implantation metastasis of HCC over the past decade, many researchers have con rmed that R-HIPEC has unique therapeutic e cacy for peritoneal metastasis of advanced HCC, which prolongs RFS and OS. Multiple studies have shown that R-HIPEC improves the RFS and OS rates in patients with peritoneal metastases of HCC.…”

“…Previously, it was mostly applied to ovarian, gastric, and colorectal cancers. [12][13][14][15] Recently, it has been gradually applied to hepato-biliary diseases; however, this practice remains relatively rare and controversial. For HCC without spontaneous rupture, Mehta et al[16] conducted a retrospective analysis of 21 patients with peritoneal metastasis of HCC and found that R-HIPEC chemotherapy drug dosage was associated with recurrence-free survival (RFS) improvement.…”

Efficacy of chemotherapy combined with surgical resection for gastric cancer with synchronous ovarian metastasis: A propensity score matching analysis

“…Moreover, previous studies have shown that HIPEC can exert a potent antitumor effect by increasing contact between tumor lesions and chemotherapeutic agents while enhancing cytotoxicity through its thermal effect. 30,31 For GC patients with peritoneal metastasis, several studies have confirmed that HIPEC can improve their survival, [32][33][34] and HIPEC has been reported as widely performed in patients with ovarian cancer. 35,36 In our study, HIPEC group showed a noteworthy improvement in survival (16.0 months vs. 13.0 months; p = 0.043), and further analysis revealed that the difference in prognosis was more significant in patients with peritoneal metastasis (13.0 months vs. 8.0 months; p = 0.007).…”