Xie Tian-Yu, Wu Di, Li Shuo, Qiu Zhao-Yan, Song Qi-Ying, Guan Da, Wang Li-Peng, Li Xiong-Guang, Duan Feng, Wang Xin-Xin
School of Medicine, Nankai University, Tianjin 300071, China.
Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.
World J Gastrointest Oncol. 2020 Jul 15;12(7):782-790. doi: 10.4251/wjgo.v12.i7.782.
Gastric cancer is the second most common malignant tumor in China, ranking third among all malignant tumor mortality rates. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs, prolong the action time of these drugs on intraperitoneal tumor cells, and enhance their diffusion in tumor tissues. HIPEC may be one of the best choices for the eradication of residual cancer cells in the abdominal cavity.
The aim of this study was to study the role of preventive HIPEC after radical gastrectomy.
A prospective analysis was performed with patients with cTNM gastric cancer to compare the effects of postoperative prophylactic HIPEC plus intravenous chemotherapy with those of routine adjuvant chemotherapy. Patients' medical records were analyzed, and differences in the peritoneal recurrence rate, disease-free survival time, and total survival time between groups were examined.
The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group ( = 0.020). The 1-year and 3-year disease-free survival rates were 91.9% and 60.4%, respectively, in the conventional adjuvant chemotherapy group and 92.1% and 63.0%, respectively, in the HIPEC group. The 1-year and 3-year overall survival rates were 95.2% and 66.3%, respectively, in the conventional adjuvant chemotherapy group and 96.1% and 68.6%, respectively, in the HIPEC group. No significant difference in postoperative or chemotherapy complications was observed between groups.
In patients with cTNM gastric cancer, prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival.
胃癌是中国第二常见的恶性肿瘤，在所有恶性肿瘤死亡率中排名第三。腹腔热灌注化疗（HIPEC）已被证明可显著提高腹腔内化疗药物的疗效，延长这些药物对腹腔肿瘤细胞的作用时间，并增强其在肿瘤组织中的扩散。HIPEC可能是根除腹腔内残留癌细胞的最佳选择之一。
本研究旨在探讨根治性胃切除术后预防性HIPEC的作用。
对cTNM期胃癌患者进行前瞻性分析，比较术后预防性HIPEC联合静脉化疗与常规辅助化疗的效果。分析患者病历，检查两组之间腹膜复发率、无病生存期和总生存期的差异。
传统辅助化疗组11例患者肿瘤复发的首发部位为腹膜，HIPEC组为2例（P = 0.020）。传统辅助化疗组1年和3年无病生存率分别为91.9%和60.4%，HIPEC组分别为92.1%和63.0%。传统辅助化疗组1年和3年总生存率分别为95.2%和66.3%，HIPEC组分别为96.1%和68.6%。两组之间术后或化疗并发症无显著差异。
对于cTNM期胃癌患者，根治性肿瘤手术后预防性HIPEC有利于降低腹膜肿瘤复发并延长生存期。
