Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer

Table 2 Meta-analyses of trials of prophylactic hyperthermic intraperitoneal chemotherapy

Author, year, outcome measure	No. of RCTs/ No. of patients	Type of IPC	Mortality	Bone marrow suppression	Intra-abdominal abscess	Anastomotic leak	Survival	Recurrence
Xu et al[86], 2004, OR	11/1161	HIPEC	NA	NA	NA	NA	0.51 (0.4-0.65; < 0.00001)	NA
		IPC ± CH
Yan et al[83], 2007, HR for survival, RR for others	10/1474	HIPEC	1.03 (0.28-3.75; 0.96)	4.33 (1.49-12.61; 0.007)	2.37 (1.49-12.61; 0.004)	1.01 (0.47-2.17; 0.98)	3-yr for HIPEC	Locoregional
		NIIC					0.60 (0.43-0.83; 0.002)	0.84 (0.30-2.31; 0.73)
		EPIC
		DPIC
Sun et al[81], 2012, RR	10/1062	HIPEC	NA	1.68 (0.62-4.58; 0.3)	NA	0.52 (0.16-1.73; 0.29)	0.73 (0.64-0.83; 0.007)	Overall
								0.45 (0.28-0.72; 0.001)
Huang et al[84], 2012, HR for survival, OR for others	10/1376	HIPEC	2.29 (0.66-9.63; 0.25)	6.74 (1.83-18.02; 0.003)	3.57 (1.49-8.67; 0.004)	1.04 (0.44-2.44; 0.10)	For HIPEC	Peritoneal recurrence 0.69 (0.36-1.33; 0.26)
		IPC + CH					0.60 (0.46-0.79; < 0.01)
		EPIC
		NIIC
Mi et al[82], 2013, RR	16/1906	HIPEC	NA	1.10 (0.53-2.29;0.8)	NA	0.86 (0.38-1.95;0.72)	5-yr	5-yr overall
							2.49 (1.97-3.14; < 0.00001)	0.47 (0.39-0.56; < 0.00001)
Coccolini et al[85], 2014, OR	12/2145	HIPEC	NA	1.82 (1.29-2.57; 0.0006)			3-yr	Peritoneal recurrence
		IPC + CH		Overall morbidity			0.31 (0.20-0.47; < 0.0001)
		EPIC						0.50 (0.37-0.68; < 0.0001)
		NIIC					5-yr
							0.89 (0.49-1.63; 0.71)

OR: Odds ratio; HR: Hazard ratio; RR: Relative risk; HIPEC: Hyperthermic intraperitoneal chemotherapy; IPC: Intraperitoneal chemotherapy; CH: Activated carbon particles; EPIC: Early postoperative intraperitoneal chemotherapy; NIIC: Normothermic intraoperative intraperitoneal chemotherapy; DPIC: Delayed postoperative intraperitoneal chemotherapy.