Prognostic value of hyperthermic intraperitoneal chemotherapy in gastric cancer with synchronous peritoneal metastases: a real-world retrospective study

• Published in: Journal of cancer research and clinical oncology 2023-12, Vol.149 (20), p.17881-17896
• Main Authors: Guo, Jianping, Deng, Zijian, Jin, Longyang, Yin, Shi, Xiong, Zhizhong, Wang, Caiqin, Chen, Huaxian, Luo, Dandong, Huang, Dayin, Peng, Junsheng, Chen, Shi, Lian, Lei
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Chemotherapy; Colorectal Neoplasms - pathology; Combined Modality Therapy; Gastric cancer; Hematology; Humans; Hyperthermia, Induced; Hyperthermic Intraperitoneal Chemotherapy; Internal Medicine; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Oncology; Patients; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - secondary; Peritoneum; Prognosis; Regression analysis; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Survival; Survival Rate; Tumors
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-023-05481-9

Purpose Peritoneal metastasis in gastric cancer (GC) is a late-stage condition with a poor prognosis. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a popular treatment for peritoneal metastases. Here, we aim to investigate the real-world application and efficacy of HIPEC alone for GC patients with synchronous peritoneal metastases. Methods We conducted a retrospective analysis on GC patients with synchronous peritoneal metastasis at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2011 and December 2022. Survival analyses and Cox regression models were performed based on overall survival (OS) and cancer-specific survival (CSS), and subgroup analysis was used to determine the prognostic value of HIPEC across different treatment. Results We enrolled 250 patients, of whom 120 (48%) received HIPEC while 130 (52%) did not. HIPEC showed no survival benefit for GC patients (P = 0.220 for OS and P = 0.370 for CSS). However, subgroup analysis found that HIPEC can only improve OS and CSS when combined with primary tumor resection (P = 0.034 for OS and P = 0.036 for CSS). Moreover, survival analyses also demonstrated that HIPEC independently improved OS (HR for OS = 0.58, 95% CI 0.37–0.92, P = 0.020) and CSS (HR for CSS = 0.58, 95% CI 0.37–0.93, P = 0.024) for patients who underwent primary site resection, but not for those who did not. Conclusion HIPEC can improve survival in GC patients with synchronous peritoneal metastases who have primary tumor resection, but not in those without primary tumor resection.