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Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study

OBJECTIVE: Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis (PM) in gastric cancer (GC). Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with complete cytoreductive surgery (CRS) has shown promising outcomes but remains controversial. The present study...

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Autores principales: Lei, Ziying, Wang, Jiahong, Li, Zhi, Li, Baozhong, Luo, Jiali, Wang, Xuejun, Wang, Jin, Ba, Mingchen, Tang, Hongsheng, He, Qingjun, Liao, Quanxing, Yang, Xiansheng, Guan, Tianpei, Liang, Han, Cui, Shuzhong, on behalf of the Chinese Peritoneal Oncology Study Group
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797229/
https://www.ncbi.nlm.nih.gov/pubmed/33447001
http://dx.doi.org/10.21147/j.issn.1000-9604.2020.06.12
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author Lei, Ziying
Wang, Jiahong
Li, Zhi
Li, Baozhong
Luo, Jiali
Wang, Xuejun
Wang, Jin
Ba, Mingchen
Tang, Hongsheng
He, Qingjun
Liao, Quanxing
Yang, Xiansheng
Guan, Tianpei
Liang, Han
Cui, Shuzhong
on behalf of the Chinese Peritoneal Oncology Study Group,
author_facet Lei, Ziying
Wang, Jiahong
Li, Zhi
Li, Baozhong
Luo, Jiali
Wang, Xuejun
Wang, Jin
Ba, Mingchen
Tang, Hongsheng
He, Qingjun
Liao, Quanxing
Yang, Xiansheng
Guan, Tianpei
Liang, Han
Cui, Shuzhong
on behalf of the Chinese Peritoneal Oncology Study Group,
author_sort Lei, Ziying
collection PubMed
description OBJECTIVE: Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis (PM) in gastric cancer (GC). Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with complete cytoreductive surgery (CRS) has shown promising outcomes but remains controversial. The present study aimed to evaluate the safety and efficacy of HIPEC without CRS in GC patients with PM. METHODS: This retrospective propensity score-matched multicenter cohort study included GC patients with PM treated with either chemotherapy alone (Cx group) or with HIPEC combined with chemotherapy (HIPEC-Cx group) in four Chinese high-volume gastric medical centers between 2010 and 2017. The primary outcomes were median survival time (MST) and 3-year overall survival (OS). Propensity score matching was performed to compensate for controlling potential confounding effects and selection bias. RESULTS: Of 663 eligible patients, 498 were matched. The MST in the Cx and HIPEC-Cx groups was 10.8 and 15.9 months, respectively [hazard ratio (HR)=0.71, 95% confidence interval (95% CI), 0.58−0.88; P=0.002]. The 3-year OS rate was 10.1% (95% CI, 5.4%−14.8%) and 18.4% (95% CI, 12.3%−24.5%) in the Cx and HIPEC-Cx groups, respectively (P=0.017). The complication rates were comparable. The time to first flatus and length of hospital stay for patients undergoing HIPEC combined with chemotherapy was longer than that of chemotherapy alone (4.6±2.4 dvs. 2.7±1.8 d, P<0.001; 14.2±5.8 dvs. 11.4±7.7 d, P<0.001), respectively. The median follow-up period was 33.2 months. CONCLUSIONS: Compared with standard systemic chemotherapy, HIPEC combined with chemotherapy revealed a statistically significant survival benefit for GC patients with PM, without compromising patient safety.
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spelling pubmed-77972292021-01-13 Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study Lei, Ziying Wang, Jiahong Li, Zhi Li, Baozhong Luo, Jiali Wang, Xuejun Wang, Jin Ba, Mingchen Tang, Hongsheng He, Qingjun Liao, Quanxing Yang, Xiansheng Guan, Tianpei Liang, Han Cui, Shuzhong on behalf of the Chinese Peritoneal Oncology Study Group, Chin J Cancer Res Original Article OBJECTIVE: Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis (PM) in gastric cancer (GC). Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with complete cytoreductive surgery (CRS) has shown promising outcomes but remains controversial. The present study aimed to evaluate the safety and efficacy of HIPEC without CRS in GC patients with PM. METHODS: This retrospective propensity score-matched multicenter cohort study included GC patients with PM treated with either chemotherapy alone (Cx group) or with HIPEC combined with chemotherapy (HIPEC-Cx group) in four Chinese high-volume gastric medical centers between 2010 and 2017. The primary outcomes were median survival time (MST) and 3-year overall survival (OS). Propensity score matching was performed to compensate for controlling potential confounding effects and selection bias. RESULTS: Of 663 eligible patients, 498 were matched. The MST in the Cx and HIPEC-Cx groups was 10.8 and 15.9 months, respectively [hazard ratio (HR)=0.71, 95% confidence interval (95% CI), 0.58−0.88; P=0.002]. The 3-year OS rate was 10.1% (95% CI, 5.4%−14.8%) and 18.4% (95% CI, 12.3%−24.5%) in the Cx and HIPEC-Cx groups, respectively (P=0.017). The complication rates were comparable. The time to first flatus and length of hospital stay for patients undergoing HIPEC combined with chemotherapy was longer than that of chemotherapy alone (4.6±2.4 dvs. 2.7±1.8 d, P<0.001; 14.2±5.8 dvs. 11.4±7.7 d, P<0.001), respectively. The median follow-up period was 33.2 months. CONCLUSIONS: Compared with standard systemic chemotherapy, HIPEC combined with chemotherapy revealed a statistically significant survival benefit for GC patients with PM, without compromising patient safety. AME Publishing Company 2020-12-31 /pmc/articles/PMC7797229/ /pubmed/33447001 http://dx.doi.org/10.21147/j.issn.1000-9604.2020.06.12 Text en Copyright © 2020 Chinese Journal of Cancer Research. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0/ This work is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
spellingShingle Original Article
Lei, Ziying
Wang, Jiahong
Li, Zhi
Li, Baozhong
Luo, Jiali
Wang, Xuejun
Wang, Jin
Ba, Mingchen
Tang, Hongsheng
He, Qingjun
Liao, Quanxing
Yang, Xiansheng
Guan, Tianpei
Liang, Han
Cui, Shuzhong
on behalf of the Chinese Peritoneal Oncology Study Group,
Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title_full Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title_fullStr Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title_full_unstemmed Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title_short Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: A multicenter propensity score-matched cohort study
title_sort hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: a multicenter propensity score-matched cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797229/
https://www.ncbi.nlm.nih.gov/pubmed/33447001
http://dx.doi.org/10.21147/j.issn.1000-9604.2020.06.12
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