Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer
Abstract
:1. Introduction
1.1. Epidemiology and Natural History of Gastric Cancer
1.2. Multimodal Treatment of Resectable Gastric Cancer
1.3. Perioperative Chemotherapy for Resectable Gastric Cancer
1.4. Adjuvant Chemotherapy and Chemoradiation
2. Approach to Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
2.1. Role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Cancers
2.2. Drugs Used in HIPEC
2.3. Intraperitoneal Chemotherapy as Neoadjuvant Approach
2.4. HIPEC as Prophylactic/Adjuvant Approach
2.5. HIPEC with Curative Intent for Cytology Positive Peritoneal Carcinomatosis
2.6. HIPEC with Curative Intent for Macroscopic Peritoneal Carcinomatosis
2.7. Early Post-Operative Intraperitoneal Chemotherapy (EPIC)
2.8. HIPEC as Palliative Approach
3. Future Areas of Study
4. Conclusions
Funding
Conflicts of Interest
References
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Author | Year | Country | Number of Patients | Agent | Outcome |
---|---|---|---|---|---|
Koga [47] | 1988 | Japan | 25 (surgery + HIPEC) vs. 21 (surgery only) | MMC 64–100 mg | 30-month OS: 83% vs. 67%, p = 0.001 |
Hamazoe [61] | 1994 | Japan | 41 (surgery + HIPEC) vs. 39 (surgery alone) | MMC 10 μg/mL | Median OS: 77 vs. 66 months 5-year OS: 64% vs. 52% |
Ikeguchi [62] | 1995 | Japan | 75 (surgery + HIPEC) vs. 96 (surgery alone) | MMC 80–100 mg/m2 | 5-year OS: 51% vs. 46% |
Fujimoto [7] | 1999 | Japan | 69 (surgery + HIPEC) vs. 68 (surgery alone) | MMC 10 mg/mL | 2, 4, 8-yr OS (88% vs. 77%, 76% vs. 58%, 62% vs. 49%) |
Hirose [63] | 1999 | Japan | 15 (surgery + HIPEC) vs. 39 (surgery alone) | MMC 20 mg, Cisplatin 100 mg, VP16 100 mg | Median OS: 33 vs. 22 months 3, 5-yr OS (49% vs 29%, 39% vs. 17%) |
Kim [57] | 2001 | Korea | 51 (surgery + HIPEC) vs. 50 (surgery alone) | MMC 40 mg | 5-yr OS: 32.7% vs. 27.1% |
Zhu [64] | 2006 | China | 41 (surgery + HIPEC) vs. 53 (surgery alone) | MMC 30 mg, Cisplatin 300 mg | 2, 4, 6-yr OS (83% vs 64%, 71% vs 52%, 68% vs 38%) |
Author | Year | Country | Number of Patients | Agent | Duration (min) | Outcome |
---|---|---|---|---|---|---|
Fujimoto [65] | 1990 | Japan | 20 (CRS + HIPEC) vs. 7 (CRS only) | MMC 10 μg/mL | 120 | 6-mo survival: 94% vs. 57%, p = 0.001 |
Yonemura [66] | 1991 | Japan | 41 | MMC 5 μg/mL Cisplatin 30 μg/mL | 40–60 | Median survival: 14.5 mo 3-yr survival: 28.5% |
Yonemura [67] | 1996 | Japan | 83 (surgery + HIPEC) | MMC 30 mg Cisplatin 300 mg Etoposide 150 mg | 60 | 5-yr survival (overall: 11%, CCR0/1: 17%, CCR2: 2%) |
Fujimoto [68] | 1997 | Japan | 48 (CRS + HIPEC) vs. 18 (CRS only) | MMC 10 μg/mL | 120 | 1, 3, 5, 8-yr survival (CRS + HIPEC vs. CRS: 54% vs. 11%, 42% vs. 0%, 31% vs. 0%, 25% vs. 0%; p = 0.001) |
Glehen [69] | 2004 | France | 49 (CRS + HIPEC) | MMC 40–60 mg | 90 | Median survival (overall: 10.3 mo; CCR0/1 vs. CCR2: 21.3 vs. 6.6 mo, p < 0.001) |
Yang [70] | 2010 | China | 28 (CRS + HIPEC) | MMC 30 mg Cisplatin 120 mg | 90–120 | 2-yr survival: 43% Median survival (PCI ≤ 20 vs PCI > 20): 27.7 vs. 6.4 mo, p = 0.0001 |
Yang [71] | 2011 | China | 34 (CRS + HIPEC) vs. 34 (CRS only) | MMC 30 mg Cisplatin 120 mg | 60–90 | Median survival (CRS + HIPEC vs. CRS): 12 vs. 6.5 mo, p = 0.02 |
Magge [72] | 2014 | USA | 23 (CRS + HIPEC) | MMC 40 mg | 100 | Median survival: 9.5 mo 3-yr survival: 18% |
Trial | Country | n | Treatment | Agent | Primary Endpoint | Estimated Completion |
---|---|---|---|---|---|---|
NCT03092518 | USA | 40 | CRS + HIPEC | Cisplatin + mitomycin C + sodium thiosulfate | Overall survival | October 2020 |
NCT02356276 | China | 584 | CRS + post-operative HIPEC + systemic chemotherapy vs. CRS alone + systemic chemotherapy | Paclitaxel | Overall survival | January 2022 |
NCT02891447 | USA | 30 | CRS + HIPEC | Mitomycin C + Cisplatin | Overall survival | September 2021 |
NCT02158988 | Germany | 180 | Neoadjuvant chemotherapy + CRS + HIPEC vs. neoadjuvant chemotherapy + CRS alone | Mitomycin C + Cisplatin | Overall survival | September 2020 |
NCT02960061 | China | 640 | Neoadjuvant chemotherapy + CRS + HIPEC + adjuvant chemotherapy vs. neoadjuvant chemotherapy + CRS + adjuvant chemotherapy | Paclitaxel | Overall survival | December 2019 |
NCT03023436 | China | 220 | CRS + HIPEC + systemic chemotherapy vs. systemic chemotherapy alone | Cisplatin + Fluoropyrimidine | Median survival | June 2022 |
NCT02969122 | China | 59 | Neoadjuvant HIPEC + neoadjuvant chemotherapy ± CRS vs. CRS + HIPEC + adjuvant chemotherapy | Docetaxel | Overall survival | December 2023 |
NCT02381847 | China | 60 | CRS + HIPEC vs. CRS alone + adjuvant chemotherapy | Cisplatin | Overall survival | March 2020 |
NCT01882933 | France | 322 | CRS + HIPEC vs. CRS alone | Oxaliplatin | Overall survival | May 2025 |
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Gamboa, A.C.; Winer, J.H. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer. Cancers 2019, 11, 1662. https://doi.org/10.3390/cancers11111662
Gamboa AC, Winer JH. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer. Cancers. 2019; 11(11):1662. https://doi.org/10.3390/cancers11111662
Chicago/Turabian StyleGamboa, Adriana C., and Joshua H. Winer. 2019. "Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer" Cancers 11, no. 11: 1662. https://doi.org/10.3390/cancers11111662