Xie TY, Wu D, Li S, Qiu ZY, Song QY, Guan D, Wang LP, Li XG, Duan F, Wang XX. Role of prophylactic hyperthermic intraperitoneal chemotherapy in patients with locally advanced gastric cancer. World J Gastrointest Oncol 2020; 12(7): 782-790 [PMID: 32864045 DOI: 10.4251/wjgo.v12.i7.782]
Corresponding Author of This Article
Xin-Xin Wang, MD, Assistant Professor, Department of General Surgery, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. 301wxx@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jul 15, 2020; 12(7): 782-790 Published online Jul 15, 2020. doi: 10.4251/wjgo.v12.i7.782
Role of prophylactic hyperthermic intraperitoneal chemotherapy in patients with locally advanced gastric cancer
Tian-Yu Xie, Di Wu, Shuo Li, Zhao-Yan Qiu, Qi-Ying Song, Da Guan, Li-Peng Wang, Xiong-Guang Li, Feng Duan, Xin-Xin Wang
Tian-Yu Xie, Shuo Li, Xiong-Guang Li, School of Medicine, Nankai University, Tianjin 300071, China
Di Wu, Zhao-Yan Qiu, Qi-Ying Song, Da Guan, Li-Peng Wang, Feng Duan, Xin-Xin Wang, Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Xie TY, Wu D, and Li S contributed equally to this work. Xie TY drafted the manuscript and assisted with data analysis; Wu D participated in design and oversight of the study and was involved with data collection; Li S participated in design of the study and was involved with data collection; Qiu ZY was involved with data collection and assisted with data analysis; Song QY drafted the manuscript and assisted with data analysis; Guan D participated in study design and performed statistical analysis; Wang LP participated in study design and performed statistical analysis; Li XG participated in design of the study and carried out selenium analyses; Duan F participated in design of the study and was involved with data collection; Wang XX drafted the manuscript and assisted with data analysis; All authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of Chinese PLA General Hospital.
Clinical trial registration statement: This study is not registered.
Informed consent statement: All study participants provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
CONSORT 2010 statement: The manuscript was checked according to the CONSORT 2010.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Xin Wang, MD, Assistant Professor, Department of General Surgery, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. 301wxx@sina.com
Received: March 4, 2020 Peer-review started: March 4, 2020 First decision: March 28, 2020 Revised: April 21, 2020 Accepted: May 26, 2020 Article in press: May 26, 2020 Published online: July 15, 2020 Processing time: 133 Days and 0.7 Hours
ARTICLE HIGHLIGHTS
Research background
Gastric cancer is the second most common malignant tumor in China, with a mortality rate of 22.04/100000, ranking third in all malignant tumor mortality rates. Local recurrence of tumors seriously affects the survival time of patients, and the peritoneum is one of the most common sites of gastric cancer recurrence. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs, prolong the action time of these drugs on intraperitoneal tumor cells, and enhance their diffusion in tumor tissues. At this time, HIPEC may be one of the best choices for the eradication of residual cancer cells in the abdominal cavity.
Research motivation
To determine whether HIPEC can reduce peritoneal recurrence in patients with gastric cancer after radical resection, more multicenter prospective clinical trials should be completed to verify the role of HIPEC.
Research objectives
The aim of this study was to study the role of preventive HIPEC after radical gastrectomy.
Research methods
The effects of postoperative prophylactic HIPEC plus intravenous chemotherapy and routine adjuvant chemotherapy for patients with cT4N0-3M0 gastric cancer were compared. Patients’ medical records were analyzed and differences in the peritoneal recurrence rate, disease-free survival time, and total survival time between groups were examined.
Research results
The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group. In the conventional adjuvant chemotherapy group, the 1-year and 3-year disease-free survival rates were 91.9% and 60.4%, respectively, and they were 92.1% and 63.0% in the HIPEC group. In the conventional adjuvant chemotherapy group, the 1-year and 3-year overall survival rates were 95.2% and 66.3%, respectively, and they were 96.1% and 68.6% in the HIPEC group. No significant difference in postoperative or chemotherapy complications was observed between groups.
Research conclusions
Prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival for patients with cT4N0-3M0 gastric cancer.
Research perspectives
We hope that this study will stimulate peers to design scientific experiments to study the therapeutic effects of preventive HIPEC. Considering the limitations of this study, more prospective randomized controlled trials with large sample sizes is warranted and will be conducted to verify the conclusions of this study.
