Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis

Objective To evaluate the clinical trials of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on gastric cancer peritoneal carcinomatosis (GC PC).

Methods The published clinical trials of CRS+HIPEC on GC PC were critically evaluated, with survival and safety as the primary endpoints.

Results The natural course of GC PC was < 5 months. CRS+HIPEC could improve the overall survival (OS). In prospective studies, the median OS was 11.0 months in the CRS+HIPEC group. In retrospective studies, the median OS was 13.3 months in the CRS+HIPEC group. The perioperative mortality was less than 6.5%, and there was no statistically significant increase in serious adverse events directly attributable to CRS+HIPEC.

Conclusion CRS+HIPEC is a promising integrated treatment strategy for GC PC to produce improved treatment efficacy, and should be recommended as the first treatment choice for selected patients with GC PC.