Published online Jul 15, 2020. doi: 10.4251/wjgo.v12.i7.782
Peer-review started: March 4, 2020
First decision: March 28, 2020
Revised: April 21, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: July 15, 2020
Gastric cancer is the second most common malignant tumor in China, with a mortality rate of 22.04/100000, ranking third in all malignant tumor mortality rates. Local recurrence of tumors seriously affects the survival time of patients, and the peritoneum is one of the most common sites of gastric cancer recurrence. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs, prolong the action time of these drugs on intraperitoneal tumor cells, and enhance their diffusion in tumor tissues. At this time, HIPEC may be one of the best choices for the eradication of residual cancer cells in the abdominal cavity.
To determine whether HIPEC can reduce peritoneal recurrence in patients with gastric cancer after radical resection, more multicenter prospective clinical trials should be completed to verify the role of HIPEC.
The aim of this study was to study the role of preventive HIPEC after radical gastrectomy.
The effects of postoperative prophylactic HIPEC plus intravenous chemotherapy and routine adjuvant chemotherapy for patients with cT4N0-3M0 gastric cancer were compared. Patients’ medical records were analyzed and differences in the peritoneal recurrence rate, disease-free survival time, and total survival time between groups were examined.
The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group. In the conventional adjuvant chemotherapy group, the 1-year and 3-year disease-free survival rates were 91.9% and 60.4%, respectively, and they were 92.1% and 63.0% in the HIPEC group. In the conventional adjuvant chemotherapy group, the 1-year and 3-year overall survival rates were 95.2% and 66.3%, respectively, and they were 96.1% and 68.6% in the HIPEC group. No significant difference in postoperative or chemotherapy complications was observed between groups.
Prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival for patients with cT4N0-3M0 gastric cancer.
We hope that this study will stimulate peers to design scientific experiments to study the therapeutic effects of preventive HIPEC. Considering the limitations of this study, more prospective randomized controlled trials with large sample sizes is warranted and will be conducted to verify the conclusions of this study.