Published online Jul 24, 2024. doi: 10.5306/wjco.v15.i7.840
Revised: May 11, 2024
Accepted: June 3, 2024
Published online: July 24, 2024
Processing time: 125 Days and 14.9 Hours
Gastric cancer presenting with peritoneal metastasis is notably associated with diminished survival prospects. The use of cytoreductive surgery in conjunction with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase survival rates in these patients. Despite these advancements, debates persist regarding the magnitude of survival improvement attributed to this treatment modality. The present investigation examined survival outcomes following HIPEC in individuals diagnosed with gastric cancer and peritoneal metastasis, and it took a comparative analysis of patients exhibiting positive and negative cytological findings.
To compare the impact of HIPEC on survival in gastric cancer patients with pe
Between April 2013 and March 2020, 84 patients with advanced gastric cancer treated at our institution were categorized into three cohorts: HIPEC (20 patients with peritoneal metastasis), cytology-positive (23 patients without peritoneal nodules but with positive wash cytology), and cytology-negative (41 patients with advanced gastric cancer, no peritoneal nodules, and negative wash cytology). The HIPEC cohort underwent gastrectomy with HIPEC, while the cytology-positive and cytology-negative groups received gastrectomy alone. The demographic, pat
The HIPEC cohort-predominantly younger females-exhibited relatively extended surgical durations and high blood loss. Nevertheless, the complication rates were consistent across all three groups. Median survival in the HIPEC group was 20.00 ± 4.89 months, with 1-year, 2-year, and 3-year overall survival rates of 73.90%, 28.70%, and 9.60%, respectively. These figures paralleled the survival rates of the cytology-positive group (52.20% at 1 year, 28.50% at 2 years, and 19.00% at 3 years). Notably, 47% of patients experienced peritoneal recurrence.
HIPEC may offer a modest improvement in short-term survival for patients with gastric cancer and peritoneal metastasis, mirroring the outcomes in cytology-positive patients. However, peritoneal recurrence remained high.
Core Tip: This investigation evaluated the survival outcomes of 84 advanced gastric cancer patients from 2013 to 2020. Among them, the hyperthermic intraperitoneal chemotherapy (HIPEC) cohort, characterized by peritoneal nodules, underwent longer surgeries and experienced greater blood loss; however, the rate of complications did not significantly differ among groups. The HIPEC group’s median survival was 20.00 ± 4.89 mo, with 1-year, 2-year, and 3-year survival rates of 73.90%, 28.70%, and 9.60%, respectively. These rates were akin to those of the cytology-positive group. While HIPEC appears to offer a survival benefit, particularly in the short term, the incidence of peritoneal recurrence remains high.