Intraoperative hyperthermic intraperitoneal chemotherapy as adjuvant chemotherapy for advanced gastric cancer patients with serosal invasion

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• 作者：Lung-Yun Kang ; King-Tong Mok ; Shiuh-Inn Liu ; Cheng-Chong Tsai ; Being-Whey Wang ; I-Shu Chen ; Yu-Chia Chen ; Bo-Min Chang ; Nan-Hua Chou
• 关键词：adjuvant chemotherapy ; intraperitoneal chemotherapy ; serosal invasion ; stomach neoplasm
• 刊名：Journal of the Chinese Medical Association
• 出版年：2013
• 出版时间：August, 2013
• 年：2013
• 卷：76
• 期：8
• 页码：425-431
• 全文大小：552 K

文摘

Background

To evaluate hyperthermic intraperitoneal chemotherapy (HIPEC) as an adjuvant chemotherapy in advanced gastric cancer (AGC) patients with serosal invasion.

Methods

Patients who received radical surgery and palliative surgery between January 2002 and December 2010 were retrospectively examined. Patients were divided into two groups, namely, one group that underwent surgery and another group that underwent surgery with HIPEC. All patients who received HIPEC had suspected serosal invasion on an abdominal computed tomography or by the surgeon's assessment during the operation.

Results

The prophylactic groups included 83 patients who underwent gastrectomy alone. A total of 29 patients underwent gastrectomy with HIPEC. The 5-year survival rates were 10.7 % and 43.9 % , respectively. The 5-year mean survival times were 22.66 (17.55-25.78) and 34.81 (24.97-44.66) months (p?=?0.029), respectively. There were 52 patients who had a recurrence of carcinomatosis among 133 patients who had resections (52/133, 39.1 % ). The 3-year disease-free survival rate for carcinomatosis was 28.87 % in the group that received surgery alone, whereas it was 66.03 % in the group that received HIPEC. There was no significant difference in the rate of complication between the two groups in the prophylactic group (p?=?0.542). Thus, curative surgery with HIPEC had a better prognosis for AGC with serosal invasion. The carcinomatosis recurrence time was longer in patients who underwent gastrectomy with HIPEC and received R0 resection.

Conclusion

The survival benefit of HIPEC as an adjuvant therapy for gastric cancer patients with serosal invasion should be validated in a large cohort.