M Yu Reutovich1, O V Krasko2, O G Sukonko3. 1. Gastroesophageal Pathology Departement, N.N. Alexandrov National Cancer Center, Minsk, Belarus. Electronic address: mihail_revtovich@yahoo.com. 2. United Institute of Informatics Problems, National Academy of Sciences, Minsk, Belarus. 3. Gastroesophageal Pathology Departement, N.N. Alexandrov National Cancer Center, Minsk, Belarus.
Abstract
BACKGROUND: Evaluation of hyperthermic intraperitoneal chemotherapy (HIPEC) in reducing metachronous peritoneal metastases (MPM) risks in patients with resectable serosa-invasive gastric cancer. MATERIALS & METHODS:Between 2008 and 2016, 154 patients with gastric cancer (stage IIB-IIIC) were randomly assigned to two groups: 76 patients underwent HIPEC (cisplatin 50 mg/m2 + doxorubicin 50 mg/m2, 42 °C, 1 h) combined with radical surgery (HIPEC group) and78 patients underwent onlyradical surgery (control group). RESULTS: Evaluation of HIPEC toxicity showed neither toxic complications of IV-V degree nor haematological toxicity (according to CTCAE v. 4.03). There was no significant difference in the rate of complications between the two groups (p = 0.254). There was a more frequent disease progression in the control group than in the HIPEC group: 42/55 patients (76.4%) vs. 36/68 patients (52.9%), respectively (p = 0.009). At the same time a significant decrease in the rate of MPM was observed after HIPEC administration as compared with surgery alone - 16/68 (12.8%) vs. 39/55 (27.6%) (p < 0.001). 3-year progression-free survival was 47% (95% CI 36-61)) in the HIPEC group and 27% (95% CI 17-43) in the control group - p = 0.0024. The N-stage, HIPEC procedure, type of surgery and interaction between HIPEC treatment and age were independent prognostic factors. CONCLUSIONS: HIPEC appears to be helpful in improving treatment results in radically operated gastric cancer patients.
RCT Entities:
BACKGROUND: Evaluation of hyperthermic intraperitoneal chemotherapy (HIPEC) in reducing metachronous peritoneal metastases (MPM) risks in patients with resectable serosa-invasive gastric cancer. MATERIALS & METHODS: Between 2008 and 2016, 154 patients with gastric cancer (stage IIB-IIIC) were randomly assigned to two groups: 76 patients underwent HIPEC (cisplatin 50 mg/m2 + doxorubicin 50 mg/m2, 42 °C, 1 h) combined with radical surgery (HIPEC group) and 78 patients underwent only radical surgery (control group). RESULTS: Evaluation of HIPEC toxicity showed neither toxic complications of IV-V degree nor haematological toxicity (according to CTCAE v. 4.03). There was no significant difference in the rate of complications between the two groups (p = 0.254). There was a more frequent disease progression in the control group than in the HIPEC group: 42/55 patients (76.4%) vs. 36/68 patients (52.9%), respectively (p = 0.009). At the same time a significant decrease in the rate of MPM was observed after HIPEC administration as compared with surgery alone - 16/68 (12.8%) vs. 39/55 (27.6%) (p < 0.001). 3-year progression-free survival was 47% (95% CI 36-61)) in the HIPEC group and 27% (95% CI 17-43) in the control group - p = 0.0024. The N-stage, HIPEC procedure, type of surgery and interaction between HIPEC treatment and age were independent prognostic factors. CONCLUSIONS: HIPEC appears to be helpful in improving treatment results in radically operated gastric cancerpatients.
Authors: Shouki Bazarbashi; Ahmed Badran; Ahmed Mostafa Gad; Ali Aljubran; Ahmed Alzahrani; Aisha Alshibani; Reem Alrakaf; Tusneem Elhassan; Abdullah Alsuhaibani; Mahmoud A Elshenawy Journal: Ann Surg Oncol Date: 2022-08-30 Impact factor: 4.339