Role of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Treatment of Peritoneal Metastasis of Gastric Cancer

Abstract Background There is no currently available treatment for peritoneal metastasis of gastric cancer. This phase II study aimed to evaluate the efficacy and safety of neoadjuvant systemic chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) for the treatment of these patients. Methods Neoadjuvant chemotherapy comprised two cycles of HIPEC and four cycles of S-1 plus paclitaxel. HIPEC was administered intraperitoneally with paclitaxel (75 mg/m2). For systemic chemotherapy, paclitaxel was administered intravenously(150 mg/m2) on day 1, and S-1 was administered orally(80 mg/m2/day)on days 1–14 of a 3-week cycle. Another two cycles of HIPEC and four cycles of S-1 plus paclitaxel were administered after second diagnostic staging laparoscopy or CRS. The primary endpoints were treatment efficiency and safety; the secondary endpoint was 3-year overall survival (OS). Results A total of 40 patients were enrolled and 38 patients have been analyzed. Of these, 18 (47.4%) patients received neoadjuvant systemic chemotherapy, HIPEC and CRS (conversion therapy group), while 20 patients received only chemotherapy and HIPEC (palliative chemotherapy group). Median OS was markedly improved in the conversion therapy group (21.1 months, 95% confidence interval [CI] 16.7–25.6 months) in comparison with the palliative chemotherapy group(10.8 months, 95%CI 7.3–14.2 months, p = 0.002). After neoadjuvant systemic chemotherapy and HIPEC, a second laparoscopic exploration was performed, and the prognosis of patients with low peritoneal cancer index (PCI) (PCI < 6) was significantly better than that of patients with high PCI (PCI ≥ 6)(20.1 vs.11.3 months, p = 0.006). Conclusion Neoadjuvant systemic chemotherapy and HIPEC combined with CRS is safe and feasible, and could potentially improve the prognosis of gastric cancer patients with limited peritoneal metastasis. However, further clinical trials are still warranted. Trial registration This study has been registered with ClinicalTrials.gov as NCT02549911. Trial registration date: 15/09/2015.

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Surgery with hyperthermic intraperitoneal chemotherapy after response to induction chemotherapy in patients with peritoneal metastasis of gastric cancer

Journal of Gastrointestinal Oncology ◽

10.21037/jgo-20-121 ◽

2021 ◽

Vol 12 (S1) ◽

pp. S47-S56

Author(s):

Emel Canbay ◽

Bahar Canbay Torun ◽

Kaan Cosarcan ◽

Cetin Altunal ◽

Bulent Gurbuz ◽

...

Keyword(s):

Gastric Cancer ◽

Induction Chemotherapy ◽

Intraperitoneal Chemotherapy ◽

Peritoneal Metastasis ◽

Hyperthermic Intraperitoneal Chemotherapy

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Hyperthermic Intraperitoneal Chemotherapy in the Management of Gastric Cancer: A Narrative Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020681 ◽

2022 ◽

Vol 19 (2) ◽

pp. 681

Author(s):

Marek Mazurek ◽

Małgorzata Szlendak ◽

Alicja Forma ◽

Jacek Baj ◽

Ryszard Maciejewski ◽

...

Keyword(s):

Gastric Cancer ◽

Intraperitoneal Chemotherapy ◽

Multimodal Treatment ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Literature Search ◽

Web Of Science ◽

Palliative Chemotherapy ◽

Treatment Options ◽

Effective Time

Gastric cancer (GC) patients with peritoneal metastasis tend to achieve poor clinical outcomes. Until recently, the treatment options were limited mainly to either palliative chemotherapy or radiation therapy in exceptional cases. Currently, these patients benefit from multimodal treatment, such as cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Despite good overall results, this treatment modality is still widely debated. The following study is designed to assess the papers about the possible application and utility of HIPEC in GC. A search in the PubMed, Web of Science, and Scopus databases was performed to assess the papers devoted to the role of HIPEC in GC treatment; a literature search was performed until March 21st; and, finally, 50 studies with a total number of 3946 patients were analyzed. According to the most recent data, it seems to be reasonable to limit the duration of HIPEC to the shortest effective time. Moreover, the drugs used in HIPEC need to have equal concentrations and the same solvent. Perioperative chemotherapy needs to be reported in detail and, furthermore, the term “morbidity” should be defined more clearly by the authors.

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Diagnosis and Management of Peritoneal Metastases from Ovarian Cancer

Gastroenterology Research and Practice ◽

10.1155/2012/541842 ◽

2012 ◽

Vol 2012 ◽

pp. 1-12 ◽

Cited By ~ 31

Author(s):

Evgenia Halkia ◽

John Spiliotis ◽

Paul Sugarbaker

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Peritoneal Metastasis ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Peritoneal Metastases ◽

Diagnostic Tools ◽

Advanced Epithelial Ovarian Cancer

The management and the outcome of peritoneal metastases or recurrence from epithelial ovarian cancer are presented. The biology and the diagnostic tools of EOC peritoneal metastasis with a comprehensive approach and the most recent literatures data are discussed. The definition and the role of surgery and chemotherapy are presented in order to focuse on the controversial points. Finally, the paper discusses the new data about the introduction of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced epithelial ovarian cancer.

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