Prognostic impact of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients: A meta-analysis of randomized controlled trials

Granieri, Stefano; Bonomi, Alessandro; Frassini, Simone; Chierici, Andrea; Bruno, Federica; Paleino, Sissi; Kusamura, Shigeki; Germini, Alessandro; Facciorusso, Antonio; Deraco, Marcello; Cotsoglou, Christian

doi:10.1016/j.ejso.2021.05.016

Cited by 47 publications

(40 citation statements)

References 29 publications

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“…However, others considered that IPC had a negative effect (17). Furthermore, hyperthermic intra-operative peritoneal chemotherapy (HIPEC) was thought to be another treatment for improving OS and DFS after gastrectomy (28). EIPL is also a currently controversial method.…”

Section: Discussionmentioning

confidence: 99%

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

et al. 2021

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PurposeThe purpose of the current meta-analysis is to analyze whether extended intraoperative peritoneal lavage (EIPL) can bring benefit on short-term outcomes or survival for patients undergoing curative gastrectomy for gastric cancer.MethodsThe PubMed, Embase, and Cochrane Library databases were searched from inception to May 3, 2021, to find eligible studies. Postoperative complications, overall survival (OS), disease-free survival (DFS), and peritoneal recurrence–free survival (PRFS) were compared between EIPL group and No EIPL group.ResultsA total of five randomized controlled trials with 1,790 patients were included in the current meta-analysis. No difference was found in baseline information (p > 0.05). After pooling up the data of overall postoperative complications, no significant difference was found between EIPL group and No EIPL group (OR = 0.88, 95% CI = 0.51 to 1.53, P = 0.65). Furthermore, there was no significant difference between EIPL group and No EIPL group in terms of OS (HR = 0.77, 95% CI = 0.36 to 1.64, P = 0.49), DFS (HR = 0.97, 95% CI = 0.71 to 1.33, P = 0.87), and PRFS (HR = 1.03, 95% CI = 0.74 to 1.43, P = 0.86). In terms of subgroup analysis of OS, no significant difference was found as well (HR = 1.05, 95% CI = 0.82 to 1.34, P = 0.69).ConclusionsEIPL did not bring benefit in terms of short-term outcomes or survival. Therefore, EIPL is not recommended for patients undergoing curative gastrectomy for gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

et al. 2021

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“…In recent years, many advances have been made in the field of sCTx as well as applying multimodal treatment regimes [1,3,8,10]. Hyperthermic intraperitoneal chemotherapy (HIPEC), pressurized intraperitoneal aerosol chemotherapy (PIPAC) and repeated intraperitoneal chemotherapy (RIPEC) in the management of peritoneal carcinomatosis in GC have emerged [4][5][6][7]9,22,23]. However, the overall outcome remains unsatisfactory with survival rates between 6 to 18 months only.…”

Section: Discussionmentioning

confidence: 99%

“…HIPEC and PIPAC have been advocated in the last few years in the management of metastatic GC patients [4][5][6][7]. However, the overall data are scarce.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, surgery is also not excluded in metastatic GC nowadays. Hyperthermic intraperitoneal chemotherapy (HIPEC), pressurized intraperitoneal aerosol chemotherapy (PIPAC) and repeated intraperitoneal chemotherapy (RIPEC) are also evaluated in the management of peritoneal carcinomatosis in GC within the multidisciplinary tumour board discussions [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Regional Chemotherapy Approach in Peritoneal Metastatic Gastric Cancer

Aigner

Vashist

Selak

et al. 2021

JCM

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Peritoneal spread is frequent in gastric cancer (GC) and a palliative condition. After failure to systemic chemotherapy (sCTx) remaining therapeutic options are very limited. We evaluated the feasibility and efficacy of locoregional chemotherapy (RegCTx) in peritoneal metastatic GC. In total, 38 (23 male and 15 female) patients with peritoneal metastatic GC after failure of previous sCTx and unresectable disease were enrolled in this study. Using the hypoxic abdominal stop-flow perfusion, upper abdominal perfusion and intraarterial infusion technique in total 114 cycles with Cisplatin, Adriamycin and Mitomycin C were applied. No significant procedure related toxicity was noticed- especially no Grade 3 or 4 toxicity occurred. With the RegCTx approach a median overall survival of 17.4 months was achieved. Patients who had undergone previously resection of the GC the median overall survival was even better with 23.5 months. RegCTx is a promising, safe and efficient approach in diffuse metastatic GC. The evaluation of RegCTx in the setting of multimodal treatment approach at less advanced stages is also warranted.

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“…Most cases of gastric cancer are advanced at diagnosis, the prognosis is extremely poor, and there is a lack of effective treatment. For some strictly selected cases, local treatment, including surgical resection and hyperthermic intraperitoneal chemotherapy, may be able to improve the prognosis of patients (1,2). Medical treatment, including chemotherapy and targeted therapy, is currently the main treatment for advanced or metastatic gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study of Sintilimab as Second-Line or Above Therapy in Patients With Advanced or Metastatic Gastric Cancer: A Retrospective Study

Nie

Liu

et al. 2021

Front. Oncol.

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BackgroundThe present study was conducted to analyze the clinical efficacy and safety of sintilimab as second-line or above therapy for patients with advanced or metastatic gastric cancer.MethodsPatients with advanced or metastatic gastric cancer that progressed after prior systemic therapies and treated with sintilimab from March 2019 to July 2020 were retrospectively analyzed in this study. The primary end point was progression-free survival (PFS). Secondary end points included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety.ResultsFifty-two patients with advanced or metastatic gastric cancer received sintilimab monotherapy or combination therapy after they failed from prior systemic therapies. Eight patients achieved partial response (PR), 26 patients had stable disease (SD), and 18 patients had progressive disease (PD). The ORR and DCR were 15.4% (8/52) and 65.4% (34/52), respectively. Median PFS was 2.5 months (95% CI = 2.0–3.0), and median OS was 5.8 months (95% CI = 4.9–6.7). The ORR and DCR were 30.0% (6/20) and 80.0% (16/20), respectively, in intestinal subtype, which were superior than in non-intestinal subtype (ORR: 6.3%, DCR: 56.3%). Patients with intestinal subtype obtained longer PFS (4.0 vs. 1.9) and OS (9.0 vs. 4.1) than those with non-intestinal subtype. The incidence of grade 3–4 adverse events was 44.2%.ConclusionsSintilimab monotherapy or combination therapy provides a feasible therapeutic strategy for patients with advanced or metastatic gastric cancer who failed from prior systemic therapies. The efficacy of sintilimab in intestinal subtype was superior than that in non-intestinal subtype.

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Prognostic impact of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in gastric cancer patients: A meta-analysis of randomized controlled trials

Cited by 47 publications

References 29 publications

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

Efficacy of Regional Chemotherapy Approach in Peritoneal Metastatic Gastric Cancer

Clinical Study of Sintilimab as Second-Line or Above Therapy in Patients With Advanced or Metastatic Gastric Cancer: A Retrospective Study

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