Advancing gastric cancer treatment: A comprehensive review of hyperthermic intraperitoneal chemotherapy’s role and outcomes

Table 1 Therapeutic use of hyperthermic intraperitoneal chemotherapy, randomized controlled trials: Study and population characteristics

Year	Ref./trial	Arms	Patients cohort	Oncologic exclusion criteria	CY+	PCI	Ascites	Liver mets	Lung mets	Syncronous/metachronous (PM/CY+)
2011	Yang et al[27]	Arm 1: CRS-A (n = 34). Arm 2: CRS-H (n = 34)	68	Any lung metastasis, liver metastasis, prominent retroperitoneal lymph node metastasis	ND	CRS-H arm: 2-36 (median: 15). CRS-A arm: 3-23 (median: 15)	ND	No	No	Synchronous [PM (n = 51)], metachronous [PM (n = 17)]
2014	Rudloff/GYMSSA	Arm 1: FOLFOXIRI alone arm-S. Cht (n = 8). Arm 2: GYMS arm— CRS-H + S. Cht (n = 9)	17	Disease sites other than either peritoneum, lung or liver. Evidence of extensive para-aortic/retro-pancreatic lymph node metastases. Significant ascites	Yes	GYMS arm: PCI ≤ 20, n = 8/9 (89%); PCI = 21, n = 1/9 (11%)	No	Yes	Yes	Synchronous [PM (n = 14); CY+ (n = 1)], metachronous [PM (n = 2)]
2023	Rau/GASTRIPEC-I	Arm 1: CRS-A (n = 53). Arm 2: CRS-H (n = 52)	105	Further distant metastases except Krukenberg tumors. Pretreated with chemotherapy/radiotherapy	No	PCI ≥ 7 (44%)	Yes (40%)	No	No	Synchronous [PM (n = 105)]

CRS-A: Cytoreductive surgery alone; CRS-H: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy; CY+: Positive peritoneal cytology; GYMS: Hyperthermic intraperitoneal chemotherapy + systemic FOLFOXIRI; ND: Not declared; PCI: Peritoneal cancer index; PM: Peritoneal metastases; S. Cht: Systemic chemotherapy.