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Prognostic Analysis of Prophylactic Hyperthermic Intraperitoneal Chemotherapy for Advanced Gastric Cancer: a Propensity Score-Matched Analysis.
Liu, Lei; Zheng, Longbo; Liu, Shanglong; Zhang, Maoshen; Zhang, Simeng; Jiang, Zinian; Qin, Chen; Wang, Dongsheng.
Afiliación
  • Liu L; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Zheng L; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Liu S; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Zhang M; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Zhang S; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Jiang Z; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
  • Qin C; Department of Oncology, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, 266042, China. qinchen12345@126.com.
  • Wang D; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China. wangdongsheng@qdu.edu.cn.
J Gastrointest Surg ; 27(11): 2297-2307, 2023 11.
Article en En | MEDLINE | ID: mdl-37715013
PURPOSE: To investigate the efficacy of prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced gastric cancer (AGC). METHODS: We included 198 patients treated from December 2016 to January 2019; of these patients, the 132 who had clinical T4 gastric cancer were divided into a hyperthermic intraperitoneal chemotherapy group (HIPEC group) and a radical gastrectomy and D2 lymph node dissection group (control group). Because this study was retrospective, we used propensity score matching (PSM) to reduce selectivity bias; we then assessed risk factors for recurrence and compared prognosis in terms of survival in the gastrectomy and prophylactic HIPEC groups. RESULTS: Prophylactic HIPEC reduced the risk of postoperative peritoneal metastasis (PM: 27.5% vs. 10.5%, P = 0.015) and did not increase the risk of postoperative complications, but there was no significant difference in the effect on hepatic metastases or other distant metastases. Risk factors for recurrence included pT4 staging and positive lymph node metastases. Both disease-free survival (DFS: HR 0.592; 95% CI 0.354-0.990; P = 0.042) and peritoneal recurrence-free survival (PFS: HR 0.314; 95% CI 0.127-0.774; P = 0.008) were better in the prophylactic HIPEC group than in the gastrectomy-only group. In addition, there was no difference in the prognosis of patients between the two groups of raltitrexed (RT) and paclitaxel (PTX) for perfusion dosing. CONCLUSION: Our study showed that prophylactic HIPEC could prevent postoperative PM in patients with AGC and did not increase the incidence of postoperative complications. However, it was not found to be effective in the prevention of other metastases, such as hepatic metastases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Hipertermia Inducida / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Hipertermia Inducida / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos