Dominic Jerry Lorren, Kannan Amudhan, Tara Anjli, Hakim Mohammed Abdul Rub, Win Myat, Khorochkov Arseni, Sultan Waleed, Ahmed Asma, Kantamaneni Ketan, Syzmanski Michael W, Singh Rajbir, Marquez Raul A, Asarian Armand, Thirunavukarasu Pragatheeshwar, Keckeisen George
General Surgery, Stony Brook Medicine/Southampton Hospital, Southampton, New York, United States.
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
EXCLI J. 2021 Aug 19;20:1328-1345. doi: 10.17179/excli2021-4108. eCollection 2021.
Peritoneal metastasis is associated with poor prognosis, with studies in the literature reporting the survival of peritoneal metastasis without treatment to be three to six months. Hyperthermic intraperitoneal chemotherapy (HIPEC) has shown positive outcomes by improving the prognosis in patients with gastrointestinal malignancies. This systematic review of randomized controlled trials was done to determine the prophylactic role of hyperthermic intraperitoneal chemotherapy in preventing and controlling peritoneal metastasis gastrointestinal origin. Randomized controlled trials published between January 2019 to June 2021 were included. The databases used were MEDLINE (PubMed), EMBASE (Ovid), and the Cochrane library. Cochrane handbook for systematic review of intervention was used to assess the risk of bias in included trials. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of five trials met the inclusion criteria. Two studies were on patients with gastric cancer, and the other three studies were on patients with colorectal cancer. HIPEC was given to a total of 116 gastric cancer patients and 308 colorectal cancer patients. In all the included studies on patients with gastric cancer, the peritoneal recurrence-free survival was significantly higher in the group that received HIPEC. There was no significant improvement in peritoneal-free survival in patients with colorectal cancer who received HIPEC. HIPEC appears to be effective in preventing peritoneal metastasis in patients with locally advanced gastric cancer without minimal postoperative complications. However, in patients with advanced colorectal malignancy, HIPEC does not seem to play a crucial role in preventing and controlling peritoneal metastasis.
腹膜转移与预后不良相关，文献研究报道未经治疗的腹膜转移患者生存期为三至六个月。腹腔热灌注化疗（HIPEC）已显示出积极效果，可改善胃肠道恶性肿瘤患者的预后。本系统评价随机对照试验旨在确定腹腔热灌注化疗在预防和控制胃肠道原发腹膜转移中的预防作用。纳入了2019年1月至2021年6月发表的随机对照试验。使用的数据库有MEDLINE（PubMed）、EMBASE（Ovid）和Cochrane图书馆。采用Cochrane干预系统评价手册评估纳入试验的偏倚风险。结果按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行报告。共有五项试验符合纳入标准。两项研究针对胃癌患者，另外三项研究针对结直肠癌患者。共有116例胃癌患者和308例结直肠癌患者接受了HIPEC治疗。在所有纳入的胃癌患者研究中，接受HIPEC治疗的组腹膜无复发生存率显著更高。接受HIPEC治疗的结直肠癌患者腹膜无瘤生存率无显著改善。腹腔热灌注化疗似乎对预防局部晚期胃癌患者的腹膜转移有效，且术后并发症极少。然而，对于晚期结直肠癌患者，腹腔热灌注化疗在预防和控制腹膜转移方面似乎并未发挥关键作用。
