Perioperative intraperitoneal chemotherapy for advanced gastric cancer

Abstract

<span style="font-family: Times New Roman; font-size: small;"> </span><p class="a"><strong><span>Background-Aims:</span></strong><span> Perioperative intraperitoneal chemotherapy either under normothermia during the early postoperative period (EPIC) or intraoperatively combined with heat (HIPEC) has been shown to improve survival after radical resection of advanced gastric cancer. The purpose of the study is to compare the effect of EPIC and HIPEC in patients undergoing D<sub>2</sub> gastrectomy for advanced gastric cancer.</span></p> <p class="a"><strong><span>Patients-Methods:</span></strong><span> Patients that received EPIC after D<sub>2</sub> gastrectomy were retrospectively compared to those that received HIPEC after D<sub>2</sub> gastrectomy. The end point of the study was the assessment of survival, and recurrences.</span></p> <p class="a"><strong><span>Results:</span></strong><span> The groups were comparable for age, gender, performance status, tumor anatomic distribution, stage, degree of differentiation, Lauren classification, hospital mortality, morbidity, and type of surgery. 5-year survival rate for HIPEC group was 68% and for EPIC group was 14% (<em>p</em>=0.0054).The recurrence rate in EPIC group was 57.9% and in HIPEC group 17.4% (<em>p</em>=0.001).</span></p> <p class="a"><strong><span>Conclusions: </span></strong><span>Patients with advanced gastric cancer undergoing D<sub>2</sub> gastrectomy in combination with HIPEC have improved survival and lower recurrence rate as compared to those undergoing D<sub>2</sub> gastrectomy in combination with EPIC.</span></p><p class="a"><strong><br /></strong></p><span style="font-family: Times New Roman; font-size: small;"> </span&gt

Cytoreductive surgery plus hyperthermic intraoperative peritoneal chemotherapy for people with peritoneal metastases from colorectal, ovarian or gastric origin: A systematic review of randomized controlled trials

“…19 The average costs of CRS þ HIPEC per patient varies from about 20,000-80,000 USD. [20][21][22][23][24][25][26] Because of these reasons, this research is important to address the significant uncertainty about the benefits of an intervention that carries potential risk of harm to patients and major costs to the NHS.…”

“…Whilst some reports have shown a 30‐day mortality after CRS + HIPEC of 1%–3%, 2 and a major complication rate of 32%, 2,18 data from high volume centers has shown that major complication rates are around 10%–15% and a 90‐day mortality of 1% 19 . The average costs of CRS + HIPEC per patient varies from about 20,000–80,000 USD 20–26 . Because of these reasons, this research is important to address the significant uncertainty about the benefits of an intervention that carries potential risk of harm to patients and major costs to the NHS.…”