Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2413-2422
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2413
Effects of cytoreductive surgery combined with hyperthermic perfusion chemotherapy on prognosis of patients with advanced gallbladder cancer
Jin-Xiu Wu, Rong Hua, Xiang-Ji Luo, Feng Xie, Li Yao
Jin-Xiu Wu, Li Yao, Department of Hepatobiliary-Pancreatic Surgery, Punan Branch of Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China
Rong Hua, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Xiang-Ji Luo, Feng Xie, Department of Biliary Tract Surgery, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai 200438, China
Author contributions: Wu JX, Yao L, and Hua R designed the manuscript; Wu JX performed the study and wrote the manuscript; Yao L supervised the report writing; Hua R contributed to the analysis; Luo XJ and Xie F supervised the report.
Supported by Shanghai Pudong New Area Health Commission’s Excellent Young Medical Talent Training Plan, No. PWRq2020-68; Shanghai Pudong New Area Health Commission Discipline Leader Training Project, No. PWRd2020-16; and Shanghai Pudong New Area Science and Technology Development Fund, No. PKJ2020-Y36.
Institutional review board statement: The Punan Branch of Renji Hospital, Shanghai Jiao Tong University School of Medicine reviewed and approved this study.
Informed consent statement: All study participants and their legal guardians provided written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The dataset is available from the corresponding author at yaolibestpn@sina.com.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Yao, MM, Associate Chief Physician, Department of Hepatobiliary-Pancreatic Surgery, Punan Branch of Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 279 Linyi Road, Pudong District, Shanghai 200125, China. yaolibestpn@sina.com
Received: June 26, 2023
Peer-review started: June 26, 2023
First decision: July 17, 2023
Revised: July 24, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: November 27, 2023
ARTICLE HIGHLIGHTS
Research background

Gallbladder cancer (GC) is one of the most deadly malignancies worldwide, with a high incidence of peritoneal metastasis, leading to poor prognosis. Despite advances in systemic chemotherapy, survival outcomes remain unsatisfactory. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed as a promising approach to improve survival and reduce postoperative complications; however, its benefits and risks remain under investigation.

Research motivation

The primary research question was: Is CRS combined with HIPEC efficient and safe for managing GC? The key issues for resolution are the benefits and risks of this combined approach, including its effect on survival rates and postoperative complications compared with CRS. Addressing these questions is paramount to providing evidence-based guidance for clinicians for GC management; it could also potentially revolutionize the treatment paradigm and improve survival rates and quality of life for these patients. Moreover, it opens avenues for further research to optimize CRS-HIPEC protocols and identify patient subgroups that could benefit the most from this approach.

Research objectives

The main objective of this study was to evaluate the efficacy and safety of CRS combined with HIPEC for managing GC. We aimed to comprehensively understand the impact of CRS-HIPEC on survival rates and postoperative complications, which is crucial for future research as it informs clinical decision-making and establishes a foundation for refining treatment protocols.

Research methods

This study employed a retrospective analysis of the medical records of patients with GC treated with CRS-HIPEC. This method allows for a thorough examination of patient outcomes and treatment complications. Additionally, this study includes a comparative analysis of patients receiving CRS, highlighting the novel aspects of the CRS-HIPEC approach.

Research results

CRS-HIPEC significantly improved the survival rates of patients with GC. This study also highlighted an increased risk of certain postoperative complications. These results contribute to the field by providing empirical evidence for the efficacy and safety of CRS-HIPEC.

Research conclusions

CRS-HIPEC significantly improves survival rates but with certain risks. Furthermore, the results of this study underscore the need for personalized patient selection to maximize benefits and minimize complications.

Research perspectives

Future research should focus on optimizing CRS-HIPEC protocols and developing criteria for patient selection, which would enhance the benefits of this approach and mitigate the potential risks. Prospective, randomized controlled trials are also needed to corroborate these findings.