[Treatment strategies of cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for gastric cancer with peritoneal metastasis: a systematic review].
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Abstract:
Peritoneal metastasis in gastric cancer is associated with rapid disease progression. Hyperthermic intraoperative peritoneal chemotherapy (HIPEC) done immediately after cytoreductive surgery (CRS) has become an important treatment for peritoneal metastasis in gastric cancer patients. However, different treatment options for HIPEC exist with potential influence on survival rates and prognosis in patients, exist. These treatment options include open or closed abdomen technique, perfusion solution, number of catheters, temperature, duration, and drug regimens. This paper aims to provide more evidence on standardization of HIPEC treatment options and technologies by systematically reviewing different drug regimens and technical approaches. The study included 2 randomized controlled trials, 3 phase I/II clinical trials, 2 prospective cohort studies, and 34 retrospective cohort studies, involving 1511 patients. The most common HIPEC option is to dissolve 50-75 mg/mKeywords:
Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
Regimen
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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ABSTRACT Peritoneal carcinomatosis (PC) indicates advanced stage cancer, which is generally associated with a poor outcome and a 6 to 12 months. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an option for treating patients with primary PC, such as mesothelioma, or secondary PC, such as colorectal cancer (CRC) or pseudomixoma. Until recently, such patients were deemed untreatable. Objective: The purpose of this study was to assess the results of CRS + HIPEC in patients with PC. Postoperative complications, mortality and survival rates were evaluated according to the diagnosis. Results: Fifty-six patients with PC, undergoing full CRS + HIPEC between October 2004 and January 2020, were enrolled. The mortality rate was 3.8% and the morbidity rate was 61.5%. Complications were significantly higher in proportion to the duration of surgery (p<0.001). The overall survival rates, as shown in the Kaplan-Meyer curve, were respectively 81%, 74% and 53% at 12, 24 and 60 months. Survival rates according to each diagnosis for the same periods were 87%, 82% and 47% in patients with pseudomixoma, and 77%, 72% and 57% in patients with CRC (log-rank 0.371, p=0.543). Conclusion: CRS with HIPEC is an option for pacients with primary or secondary PC. Although complication rates are high, a longer survival rate may be attained compared to those seen in previously published results; in some cases, patients may even be cured.
Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
Radical surgery
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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Hyperthermic Intraperitoneal Chemotherapy
Intraperitoneal Chemotherapy
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