Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer

World Journal of Gastroenterology : WJG
Ramakrishnan Ayloor Seshadri, O Glehen

Abstract

Gastric cancer associated peritoneal carcinomatosis (GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase the survival in GCPC. Since recurrent gastric cancer remains confined to the abdominal cavity in many patients, regional therapies like aggressive cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been investigated for GCPC. HIPEC has been used for three indications in GC- as an adjuvant therapy after a curative surgery, HIPEC has been shown to improve survival and reduce peritoneal recurrences in many randomised trials in Asian countries; as a definitive treatment in established PC, HIPEC along with CRS is the only therapeutic modality that has resulted in long-term survival in select groups of patients; as a palliative treatment in advanced PC with intractable ascites, HIPEC has been shown to control ascites and reduce the need for frequent paracentesis. While the results of randomised trials of adjuvant HIPEC from western centres are awaited, the role of HIPEC in the treatment of GCPC is still evolving and needs larger studies before it is accepted as a standard of care.

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Citations

Jan 27, 2017·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Zhong-He JiYan Li
Jun 20, 2018·Asia-Pacific Journal of Clinical Oncology·Hwee Leong TanMelissa Ching Ching Teo
Dec 3, 2016·Langenbeck's Archives of Surgery·Hisahiro HosogiYoshiharu Sakai
Apr 18, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·J C MolinaL E Ferri
Aug 31, 2020·World Journal of Gastrointestinal Oncology·Tian-Yu XieXin-Xin Wang
Jun 27, 2018·Journal of Bioenergetics and Biomembranes·Sonata TrumbeckaiteAntanas Gulbinas
Apr 10, 2021·Current Problems in Surgery·John H StewartKonstantinos I Votanopoulos

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