Efficacy and safety of intraperitoneal chemotherapy in patients with advanced gastric cancer: a cumulative meta-analysis of randomized controlled trials

// Zheng He 1 , Ting-Ting Zhao 2 , Hui-Mian Xu 3 , Zhen-Ning Wang 3 , Ying-Ying Xu 2 , Yong-Xi Song 3 , Zhong-Ran Ni 3, 4 , Hao Xu 5 , Song-Cheng Yin 3 , Xing-Yu Liu 3 and Zhi-Feng Miao 3 1 Department of Radiation Oncology, First Hospital of China Medical University, Shenyang, Liaoning Province, China 2 Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China 3 Department of Surgical Oncology, First Hospital of China Medical University, Shenyang, Liaoning Province, China 4 School of Life Science, University of Technology Sydney, Ultimo, New South Wales, Australia 5 Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China Correspondence to: Zhi-Feng Miao, email: zfmiao@cmu.edu.cn Keywords: gastric cancer, intraperitoneal chemotherapy, prognosis, meta-analysis Received: July 10, 2017      Accepted: August 23, 2017      Published: September 11, 2017 ABSTRACT Even when a curative gastrectomy is conducted, the majority of advanced gastric cancer patients with invasion die due to peritoneal recurrence. We performed electronic searches to identify randomized controlled trials published through April 2017 evaluating the effect of intraperitoneal chemotherapy (IPC) on survival rates. We included 23 trials reporting data on 2,767 patients with advanced gastric cancer. Overall, we noted that patients who received IPC had a significantly increased 1-year survival rate, and the treatment effect of IPC on 1-year survival was most prominent in studies conducted in Japan or those with a mean age of less than 60 years. IPC was also associated with an increased incidence of 2-year survival rate, but it was not seen to have this effect in studies conducted in China or Australia or with a mean age greater than 60 years. Similarly, IPC associated with a significantly increased 3-year survival rate, but this difference was not detected in studies conducted in Austria or with a mean age greater than 60 years. IPC has no significant effect on the 5-year survival rate. Finally, IPC was associated with a lower risk of recurrence in patients with advanced gastric cancer. The findings of this study suggest that gastric cancer patients who receive IPC associate with increased 1-year, 2-year, and 3-year survival rates, but this does not extend out to a 5-year survival rate. IPC is also shown to play a protective role against the risk of recurrence in patients with advanced gastric cancer.