Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases  

作　　者：Heinrich Steinhoff Miklos Acs Sebastian Blaj Magdolna Dank Magdolna Herold Zoltan Herold Jonas Herzberg Patricia Sanchez-Velazquez Tim Strate Attila Marcell Szasz Pompiliu Piso 

机构地区：[1]Department of General and Visceral Surgery,Hospital Barmherzige Brüder,Regensburg 93049,Germany [2]Division of Oncology,Department of Internal Medicine and Oncology,Semmelweis University,Budapest 1083,Hungary [3]Department of Internal Medicine and Hematology,Semmelweis University,Budapest 1088,Hungary [4]Department of Surgery,Krankenhaus Reinbek St.Adolf-Stift,Reinbek 21465,Germany [5]Department of General Surgery,Hospital del Mar,Barcelona 08003,Spain

出　　处：《World Journal of Gastroenterology》2023年第18期2850-2863,共14页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Advanced gastric cancer with synchronous peritoneal metastases(GC-PM)is associated with a poor prognosis.Although cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC)is a promising approach,only a limited number of Western studies exist.AIM To investigate the clinicopathological outcomes of patients who underwent CRSHIPEC for GC-PM.METHODS A retrospective analysis of patients with GC-PM was conducted.All patients were seen at the Department of General and Visceral Surgery,Hospital Barmherzige Brüder,Regensburg,Germany between January 2011 and July 2021 and underwent CRS-HIPEC.Preoperative laboratory results,the use of neoadjuvant trastuzumab,and the details of CRS-HIPEC,including peritoneal carcinomatosis index,completeness of cytoreduction,and surgical procedures were recorded.Disease-specific(DSS),and overall survival(OS)of patients were calculated.RESULTS A total of 73 patients were included in the study.Patients treated with neoadjuvant trastuzumab(n=5)showed longer DSS(P=0.0482).Higher white blood cell counts(DSS:P=0.0433)and carcinoembryonic antigen levels(OS and DSS:P<0.01),and lower hemoglobin(OS and DSS:P<0.05)and serum total protein(OS:P=0.0368)levels were associated with shorter survival.Longer HIPEC duration was associated with more advantageous median survival times[60-min(n=59):12.86 mo;90-min(n=14):27.30 mo],but without statistical difference.To obtain additional data from this observation,further separation of the study population was performed.First,propensity score-matched patient pairs(n=14 in each group)were created.Statistically different DSS was found between patient pairs(hazard ratio=0.2843;95%confidence interval:0.1119-0.7222;P=0.0082).Second,those patients who were treated with trastuzumab and/or had human epidermal growth factor receptor 2 positivity(median survival:12.68 mo vs 24.02 mo),or had to undergo the procedure before 2016(median survival:12.68 mo vs 27.30 mo;P=0.0493)were removed from the original study population.CONCLUSION Based on our e

关 键 词：Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Peritoneal metastasis Stomach neoplasms Gastric cancer 

分 类 号：R730[医药卫生—肿瘤]