Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis:A multicenter propensity scorematched cohort study

作     者：Ziying Lei Jiahong Wang Zhi Li Baozhong Li Jiali Luo Xuejun Wang Jin Wang MingchenBa Hongsheng Tang Qingjun He Quanxing Liao Xiansheng Yang Tianpei Guan Han Liang Shuzhong Cui Ziying Lei;Jiahong Wang;Zhi Li;Baozhong Li;Jiali Luo;Xuejun Wang;Jin Wang;Mingchen Ba;Hongsheng Tang;Qingjun He;Quanxing Liao;Xiansheng Yang;Tianpei Guan;Han Liang;Shuzhong Cui

作者机构：Department of Abdominal SurgeryAffiliated Cancer Hospital&Institute of Guangzhou Medical UniversityGuangzhou 510095China Department of General SurgeryAffiliated Tumor Hospital of Zhengzhou UniversityTumor Hospital of Henan ProvinceZhengzhou 450008China Department of SurgeryAnyang Tumor HospitalAnyang 455000China Department of OncologyGuangzhou Medical UniversityGuangzhou 510095China Department of Gastrointestinal CancerTianjin Medical University Cancer Institute&HospitalNational Clinical Research Center of CancerKey Laboratory of Cancer Prevention and TherapyTianjin's Clinical Research Center for CancerTianjin 300060China 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2020年第32卷第6期

页      面：794-803页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：the Guangzhou Key Medical Discipline Construction Project Fund the Guangzhou High-Level Clinical Key Specialty Construction the Clinical Research Promotion Project of Guangzhou Medical University for Building High Level University the National Natural Science Foundation of China(No.81972918) the Guangzhou Major Clinical Technology Program(No.2019ZD16)。 

主　　题：Gastric cancer peritoneal metastasis hyperthermic intraperitoneal chemotherapy chemotherapy 

摘      要：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 d vs.2.7±1.8 d,P0.001;14.2±5.8 d vs.11.4±7.7 d,P0.001),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.