Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease

Khan, Hamza; Johnston, Fabian M.

doi:10.1002/jso.26894

Cited by 24 publications

(13 citation statements)

References 79 publications

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“…HIPEC has also been reported to have favorable intraoperative blood loss, postoperative outcomes, and shorter hospital stays [ 19 ]. Although limited by the lack of well-designed clinical trials, retrospective studies suggest that HIPEC may improve survival rates, reduce peritoneal recurrence, and increase disease-free intervals, particularly in patients with limited peritoneal disease burden and adequately resected primary tumors [ 20 ]. However, further research is needed to establish the optimal use of HIPEC in PGC, including refining patient selection criteria, standardizing HIPEC techniques, and investigating the optimal timing and chemotherapy regimens.…”

Section: Discussionmentioning

confidence: 99%

Perforated Gastric Cancer: A Case Report and Literature Review

Wang,

Thida,

Seong

et al. 2024

Cureus

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Gastric cancer perforation is a rare but life-threatening complication of gastric cancer. We present the case of a 53-year-old male with acquired immune deficiency syndrome (AIDS) who presented to the emergency department with severe abdominal pain, was found to have an acute abdomen, and was eventually diagnosed with gastric perforation due to metastatic gastric cancer. This case highlights the challenges in diagnosing and managing perforated gastric cancer and discusses the surgical management options, including the use of laparoscopic techniques and the role of chemotherapy, particularly hyperthermic intraperitoneal chemotherapy (HIPEC).

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Section: Discussionmentioning

confidence: 99%

Perforated Gastric Cancer: A Case Report and Literature Review

Wang,

Thida,

Seong

et al. 2024

Cureus

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“…Gastric cancer (GC) is the fifth most common cancer worldwide considering both sexes [ 20 ]. This aggressive malignancy can give a wide variety of metastases, whereby up to 40 % of GC patients have synchronous and 46 % metachronous peritoneal metastases after curative surgery [ 21 ]. Gastric cancer with peritoneal carcinomatosis has poor prognosis, with an average survival of barely 3–6 months if treated with conventional systemic therapy only [ 21 , 22 ].…”

Section: Gastric Cancermentioning

confidence: 99%

“…This aggressive malignancy can give a wide variety of metastases, whereby up to 40 % of GC patients have synchronous and 46 % metachronous peritoneal metastases after curative surgery [ 21 ]. Gastric cancer with peritoneal carcinomatosis has poor prognosis, with an average survival of barely 3–6 months if treated with conventional systemic therapy only [ 21 , 22 ]. To improve survival, CRS and HIPEC have emerged as a therapeutic alternative for selected patients.…”

Section: Gastric Cancermentioning

confidence: 99%

Current clinical practices of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

Acs,

Babucke,

Jusufi

et al. 2024

Innovative Surgical Sciences

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Treatment of peritoneal surface malignancies makes physicians face demanding and new-fangled problems, as there are many uncertain aspects considering the outcomes of affected patients’ prognoses. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are associated with favorable long-term outcomes in carefully selected patients with peritoneal metastases (PM). We aim to summarize the current results about the initial malignancies and their peritoneal spreads. The current literature has been scrutinized, and studies between 2016 and 2022 were included wherein long-term, progression-free (PFS), and overall survival (OS) data were considered relevant information. Medline, Embase, and Google Scholar have been the main sources. Hereby, we cover all the primer malignancies: gastric, ovarian, and colorectal cancers with peritoneal metastases (PM), malignant peritoneal mesothelioma, and pseudomyxoma peritonei. Examining the advances in the current peer-reviewed literature about the indications of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), target groups, risk factors, and other influencing elements, we intend to provide a complex state-of-the-art report, establishing the relevant aspects of that emerging treatment method.

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“…According to the National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) recommendations, management of metastatic disease should involve systemic therapy and best supportive care [ 9 , 10 ]. Of note, since intravenous chemotherapy has limited ability to cross the blood-peritoneal barrier, a need for alternative treatment strategies to improve outcomes in GC patients with PM have been proposed [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy (HIPEC), Oncological Outcomes and Long-Term Survival among Patients with Gastric Cancer and Limited Peritoneal Disease Progression after Neoadjuvant Chemotherapy

Kobiałka,

Sędłak,

Pelc

et al. 2023

JCM

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Introduction: The role of surgery in stage IV gastric cancer with peritoneal metastasis (PM) remains unclear. The objective of the current single-center study was to define the impact of gastrectomy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) on outcomes among Central European GC patients with limited peritoneal disease progression after neoadjuvant chemotherapy (NAC). Methods: Patients with histologically confirmed GC who underwent curative-intent multimodal treatment between 2013 and 2023 were included. Patients without adenocarcinoma, who did not undergo gastrectomy, had early (cT1) or metastatic GC at the time of initial diagnosis, who underwent multivisceral resection, incomplete cytoreduction or palliative care, died before planned curative-intent treatment, or had incomplete clinical or pathological missing information were excluded. Results: A total of 74 patients who underwent curative-intent treatment for GC with PM were included in the final analytic cohort. Patients who underwent gastrectomy with CRS+HIPEC were less likely to achieve TOO (CRS+HIPEC: 28% vs. CRS: 57.1%, p = 0.033) compared with individuals after CRS alone. Specifically, patients who underwent gastrectomy with CRS+HIPEC had a higher likelihood of postoperative complications (CRS+HIPEC: 48% vs. CRS: 20.4%, p = 0.018) and longer hospital LOS (median, CRS+HIPEC: 12 vs. CRS: 10, p = 0.019). While administration of HIPEC did not impact long-term survival (median OS, CRS+HIPEC: 16 months vs. CRS: 12 months, p = 0.55), postoperative complications (median OS, CCI < 30:16 months vs. CCI > 30:5 months, p = 0.024) and ICU stay (median OS, no ICU stay: 16 months vs. ICU stay: 5 months, p = 0.008) were associated with worsened long-term survival among GC patients with PM. Conclusions: Data from the current study demonstrated a lack of survival benefit among advanced GC patients with PM undergoing gastrectomy with CRS+HIPEC when compared with individuals after gastrectomy with CRS alone. Administration of perioperative chemotherapy and achievement of TO failed to withstand the peritoneal disease progression during NAC.

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Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease

Cited by 24 publications

References 79 publications

Perforated Gastric Cancer: A Case Report and Literature Review

Perforated Gastric Cancer: A Case Report and Literature Review

Current clinical practices of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

Hyperthermic Intraperitoneal Chemotherapy (HIPEC), Oncological Outcomes and Long-Term Survival among Patients with Gastric Cancer and Limited Peritoneal Disease Progression after Neoadjuvant Chemotherapy

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