Role of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Treatment of Peritoneal Metastasis of Gastric Cancer

This study was conducted to verify the effects of cytoreductive surgery (CRS) combined with perioperative chemotherapy (POC), using neoadjuvant intraperitoneal/systemic chemotherapy (NIPS), extensive intraperitoneal lavage (EIPL), and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis from gastric cancer (GC-PM). Combination of these treatments is called “comprehensive treatment.” The survival rate after comprehensive treatment was significantly superior to that after systemic chemotherapy. Complete cytoreduction and peritoneal cancer index (PCI) less than cutoff level after NIPS are independent prognostic factors. NIPS could bring stage reduction of PM and eradicate micrometastasis in the peritoneal cavity, resulting in an increase in complete cytoreduction rate of PM. At present, 10% of GC-PM can be cured by the comprehensive treatment because micrometastasis left behind after complete cytoreduction of macroscopic PM might be completely eradicated by HIPEC and postoperative chemotherapy.