Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases

Figure 1 Timeline of the study. HIPEC: Hyperthermic intraperitoneal chemotherapy.

Figure 2 Improvement of the operating times of cytoreductive surgery (excluding hyperthermic intraperitoneal chemotherapy) in our surgical center during the study period. HIPEC: Hyperthermic intraperitoneal chemotherapy.

Figure 3 Differences in disease-specific survival between patients with gastric cancer who underwent cytoreductive surgery and 60 min or 90 min hyperthermic intraperitoneal chemotherapy. The dotted line represents median survival. CRS: Cytoreductive surgery; HIPEC: Hyperthermic intraperitoneal chemotherapy.

Figure 4 Differences in recurrence-free survival between patients with gastric cancer of different histological types who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. ACD: Diffuse type adenocarcinoma; ACI: Intestinal type adenocarcinoma; CRS: Cytoreductive surgery; HIPEC: Hyperthermic intraperitoneal chemotherapy; SRC: Signet-ring cell adenocarcinoma.

Figure 5 Gamma-glutamyl transferase and total protein levels in 60 min and 90 min hyperthermic intraperitoneal chemotherapy groups. Clinically abnormal serum levels of gamma-glutamyl transferase (crude P = 0.0407) and total protein (crude P = 0.0570) were observed more often in those gastric cancer patients who received hyperthermic intraperitoneal chemotherapy (HIPEC) for 60 min after the cytoreductive surgery. Thick lines and hollow circles represent the median and outliers, respectively. A: Gamma-glutamyl transferase; B: Total protein.

Figure 6 Differences in disease-specific survival between propensity score in matched gastric cancer patient-pairs. Patients were matched by age, sex, peritoneal carcinomatosis index score, Jacquet and Sugarbaker’s completeness of cytoreduction score, time spent in the intensive care unit after cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC), duration of CRS, and presence of lymph node metastasis (stage N = 0 vs stage N ≥ 1). The dotted line represents median survival.