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Prognostic factors of early recurrence after complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2024年第27期12卷 6057-6069页

作者： Chao-Yu Chen Tzu-Hao Huang Li-Wen Lee Jrhau Lung Yu-Che Ou Chien-Hui Hung Huei-Chieh Chuang Min-Chi Chen Ting-Yao Wang Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayi 613Taiwan Graduate Institute of Clinical Medical Sciences College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiung 821Taiwan Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayi 613Taiwan College of Medicine Chang Gung UniversityTaoyuan 333Taiwan Department of Medical Research and Development Chang Gung Memorial HospitalChiayi 613Taiwan Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalChiayi 613Taiwan Department of Public Health Chang Gung UniversityTaoyuan 333Taiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayi 613Taiwan

BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary *** To identify the clinical factors associated with progression-free survival(PFS)after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal,ovarian,and gastric *** We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival(OS)in patients recruited between 2015 and *** regression models were used to assess the prognostic factors for the risk of recurrence within 1 ***–Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and *** Of the 80 enrolled patients,39 had an unfavorable PFS(12 was associated with a lower rate of achieving CC-0(P=0.027).The favorable PFS group had a significantly longer OS(median 81.7 mo vs 17.0 mo,P<0.001).CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term *** study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.

关键词： Peritoneal metastasis Cytoreductive surgery hyperthermic intraperitoneal chemotherapy Predictor Recurrence

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Impact of hyperthermic intraperitoneal chemotherapy on gastric cancer survival: Peritoneal metastasis and cytology perspectives

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World Journal of Clinical Oncology 2024年第7期15卷 840-847页

作者： Asada Methasate Thammawat Parakonthun Thita Intralawan Chawisa Nampoolsuksan Jirawat Swangsri Minimally Invasive Surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Upper Gastrointestinal Cancer Center Siriraj Hospital Mahidol UniversityBangkok 10700Thailand

BACKGROUND Gastric cancer presenting with peritoneal metastasis is notably associated with diminished survival *** use of cytoreductive surgery in conjunction with hyperthermic intraperitoneal chemotherapy(HIPEC)has been shown to increase survival rates in these *** these advancements,debates persist regarding the magnitude of survival improvement attributed to this treatment *** present investigation examined survival outcomes following HIPEC in individuals diagnosed with gastric cancer and peritoneal metastasis,and it took a comparative analysis of patients exhibiting positive and negative cytological *** April 2013 and March 2020,84 patients with advanced gastric cancer treated at our institution were categorized into three cohorts:HIPEC(20 patients with peritoneal metastasis),cytology-positive(23 patients without peritoneal nodules but with positive wash cytology),and cytology-negative(41 patients with advanced gastric cancer,no peritoneal nodules,and negative wash cytology).The HIPEC cohort underwent gastrectomy with HIPEC,while the cytology-positive and cytology-negative groups received gastrectomy *** demographic,pat-hological,and survival data of the groups were *** The HIPEC cohort-predominantly younger females-exhibited relatively extended surgical durations and high blood ***,the complication rates were consistent across all three *** survival in the HIPEC group was 20.00±4.89 months,with 1-year,2-year,and 3-year overall survival rates of 73.90%,28.70%,and 9.60%,*** figures paralleled the survival rates of the cytology-positive group(52.20%at 1 year,28.50%at 2 years,and 19.00%at 3 years).Notably,47%of patients experienced peritoneal *** HIPEC may offer a modest improvement in short-term survival for patients with gastric cancer and peritoneal metastasis,mirroring the outcomes in cytology-positive ***,peritoneal recurrence r

关键词： Cytoreductive surgery Gastric cancer hyperthermic intraperitoneal chemotherapy Peritoneal metastasis Positive cytology

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hyperthermic intraperitoneal chemotherapy and colorectal cancer:From physiology to surgery

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World Journal of Clinical Cases 2022年第30期10卷 10852-10861页

作者： Giorgio Ammerata Rosalinda Filippo Carmelo Laface Riccardo Memeo Leonardo Solaini Davide Cavaliere Giuseppe Navarra Girolamo Ranieri Giuseppe Currò Michele Ammendola Department Digestive Surgery UnitUniversity“Magna Graecia”Medical SchoolCatanzaro 88100Italy Interventional Oncology Unit with Integrated Section of Translational Medical Oncology National Cancer Research Centre“Giovanni Paolo Ⅱ”Bari 70124Italy Hepato-Biliary and Pancreatic Surgical Unit “F.Miulli”HospitalAcquaviva delle FontiBari 70124Italy Department of Medical and Surgical Sciences University of BolognaForlì40126Italy Department of General and Oncologic Surgery Morgagni-Pierantoni HospitalForlì47121Italy Department of Human Pathology of Adult and Evolutive Age Surgical Oncology Division“G.Martino”HospitalUniversity of MessinaMessina 98122Italy

The pursuit of this paper is to collect principal reviews and systematic reviews about hyperthermic intraperitoneal chemotherapy(HIPEC) and cytoreductive surgery(CRS) used in colorectal cancer(CRC).We focus on principal biological aspects of CRC,hyperthermia effects,and surgical *** searched PubMed/MEDLINE for the principal reviews and systematic reviews published from 2010 to 2021 regarding the bimodal treatment(CRS + HIPEC) against local and advanced *** the literature,from several studies,it seems that the efficacy of bimodal treatment with an accurate CRS can extend overall *** these studies,there are not still any straight guidelines more detailed and scheduled about the use of combined treatment in patients with *** if the concept is still not very clear and shared,after a careful evaluation of the published data,and after some technical and pathophysiological descriptions,we concluded that it is possible to improve the overall survival and quality of life and to reduce the tumor relapse in patients affected by locally advanced(pT4) CRC with peritoneal metastases.

关键词： hyperthermic intraperitoneal chemotherapy Colorectal cancer Peritoneum Cytoreductive surgery

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

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Chinese Journal of Cancer Research 2020年第6期32卷 794-803页

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 Department of Abdominal Surgery Affiliated Cancer Hospital&Institute of Guangzhou Medical UniversityGuangzhou 510095China Department of General Surgery Affiliated Tumor Hospital of Zhengzhou UniversityTumor Hospital of Henan ProvinceZhengzhou 450008China Department of Surgery Anyang Tumor HospitalAnyang 455000China Department of Oncology Guangzhou Medical UniversityGuangzhou 510095China Department of Gastrointestinal Cancer Tianjin Medical University Cancer Institute&HospitalNational Clinical Research Center of CancerKey Laboratory of Cancer Prevention and TherapyTianjin's Clinical Research Center for CancerTianjin 300060China

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 *** present study aimed to evaluate the safety and efficacy of HIPEC without CRS in GC patients with ***: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 *** 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 ***:Of 663 eligible patients,498 were *** 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 *** 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,Pchemotherapy,HIPEC combined with chemotherapy revealed a statistically significant survival benefit for GC patients with PM,without compromising patient safety.

关键词： Gastric cancer peritoneal metastasis hyperthermic intraperitoneal chemotherapy chemotherapy

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

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World Journal of Gastroenterology 2023年第18期29卷 2850-2863页

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 Department of General and Visceral Surgery Hospital Barmherzige BrüderRegensburg 93049Germany Division of Oncology Department of Internal Medicine and OncologySemmelweis UniversityBudapest 1083Hungary Department of Internal Medicine and Hematology Semmelweis UniversityBudapest 1088Hungary Department of Surgery Krankenhaus Reinbek St.Adolf-StiftReinbek 21465Germany Department of General Surgery Hospital del MarBarcelona 08003Spain

BACKGROUND Advanced gastric cancer with synchronous peritoneal metastases(GC-PM)is associated with a poor *** cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC)is a promising approach,only a limited number of Western studies *** To investigate the clinicopathological outcomes of patients who underwent CRSHIPEC for *** A retrospective analysis of patients with GC-PM was *** patients were seen at the Department of General and Visceral Surgery,Hospital Barmherzige Brüder,Regensburg,Germany between January 2011 and July 2021 and underwent *** laboratory results,the use of neoadjuvant trastuzumab,and the details of CRS-HIPEC,including peritoneal carcinomatosis index,completeness of cytoreduction,and surgical procedures were ***-specific(DSS),and overall survival(OS)of patients were *** A total of 73 patients were included in the *** 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 *** 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 *** obtain additional data from this observation,further separation of the study population was ***,propensity score-matched patient pairs(n=14 in each group)were *** 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 orig

关键词： Cytoreductive surgery hyperthermic intraperitoneal chemotherapy Peritoneal metastasis Stomach neoplasms Gastric cancer

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Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2022年第32期10卷 11775-11788页

作者： Ya-Fen Wang Ting-Yao Wang Tzu-Ting Liao Meng-Hung Lin Tzu-Hao Huang Meng-Chiao Hsieh Vincent Chin-Hung Chen Li-Wen Lee Wen-Shih Huang Chao-Yu Chen Cancer Center Chang Gung Memorial HospitalChiayiTaiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayiTaiwan Division of Case Management Cancer CenterChang Gung Memorial HospitalChiayiTaiwan Health Information and Epidemiology Laboratory Chang Gung Memorial HospitalChiayiTaiwan Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Division of Colorectal Surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Department of Psychiatry Chang Gung Memorial HospitalChiayi and Chang Gung UniversityTaoyuanTaiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayiTaiwanCollege of MedicineChang Gung UniversityTaoyuanTaiwan Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayiTaiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiungTaiwanDepartment of Early Childhood Care and EducationShu-Zen Junior College of Medicine and ManagementKaohsiungTaiwan

BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)for peritoneal surface malignancy can effectively control the disease,however it is also associated with adverse effects which may affect quality of life(QoL).AIM To investigate early perioperative QoL after CRS/HIPEC,which has not been discussed in *** This single institution,observational cohort study enrolled patients who received CRS/*** assessed QoL using the Taiwan residents version of the MD Anderson Symptom Inventory(MDASI-T)and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30).Participants completed the questionnaires before CRS/HIPEC(S1),at the first outpatient follow-up(S2),and 3 mo after CRS/HIPEC(S3).RESULTS Fifty-eight patients were *** was no significant perioperative difference in global health *** changes in physical and role functioning scores decreased at S2,and fatigue and pain scores increased at S2 but returned to baseline at *** regression analysis showed that age and performance status were significantly correlated with *** the MDASI-T questionnaire,distress/feeling upset and lack of appetite had the highest scores at S1,compared to fatigue and distress/feeling upset at S2,and fatigue and lack of appetite at *** leading interference items were working at S1 and S2 and activity at ***-T scores were significantly negatively correlated with the EORTC QLQ-C30 *** QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/*** findings can help with preoperative consultation and perioperative care.

关键词： Cytoreductive surgery hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis Quality of life Symptom distress Perioperative care

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Elemene-containing hyperthermic intraperitoneal chemotherapy combined with chemotherapy for elderly patients with peritoneal metastatic advanced gastric cancer

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World Journal of Clinical Cases 2022年第5期10卷 1498-1507页

作者： Zhi-Xiong Chen Jin Li Wen-Bin Liu Shou-Ru Zhang Hao Sun Department of Gastrointestinal Cancer Center Chongqing University Cancer HospitalChongqing 400030China Department of Ultrasound The Fifth People's Hospital of ChongqingChongqing 400062China Department of Hepatobiliary and Pancreatic Oncology Chongqing University Cancer HospitalChongqing 400030China Department of Teaching and Research Section Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND Almost all elderly patients with peritoneal metastatic gastric cancer(PGC)are unlikely to tolerate cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(HIPEC)and adjuvant ***,determining how to optimize the treatment strategy for such patients has always been a clinical *** HIPEC and palliative adjuvant chemotherapy can benefit patients with ***,optimizing HIPEC and chemotherapy regimens has potential clinical value in reducing side effects,and improving treatment tolerance and clinical *** To explore the effect of HIPEC containing elemene,which is an anti-cancer component extracted in traditional Chinese herbal medicine,combined with reduced capecitabine and oxaliplatin(CapeOx)chemotherapy regimens,in elderly patients with *** In the present study,39 of 52 elderly PGC patients were included and assigned to different HIPEC treatment groups[lobaplatin group(group L)and mixed group(group M)]for *** was used for all three HIPECs in group *** group M,lobaplatin was used in the middle of the three HIPECs,and elemene was used for the first and third *** HIPEC,patients received CapeOx *** incidence of complications(abdominal infection,lung infection,and urinary tract infection),myelosuppression,immune function(CD4/CD8 ratio),average length of hospital stay,and prognosis were compared between these two *** There was no significant difference in the incidence of complications between the two groups during hospitalization(P>0.05).Compared to patients in group M,patients in group L exhibited severe myelosuppression(P=0.027)and increased length of hospital stay(P=0.045).However,no overall survival benefit was observed in group ***,the immune function of patients in group M was less affected(Pchemotherapy after perfusion s

关键词： Gastric cancer hyperthermic intraperitoneal chemotherapy Peritoneal metastasis Oxaliplatin Capecitabine

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of gastric cancer with peritoneal carcinomatosis

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Chinese Journal of Cancer Research 2017年第1期29卷 86-92页

作者： Lynne M.Ellison Yangao Man Alexander Stojadinovic Hongwu Xin Itzhak Avital Bon Secours Cancer Institute Bon Secours Health System Richmond VA 23226 USA Laboratory of Oncology the First People's Hospital of Jingzhou City the First Hospital and Clinical Medical School of Yangtze University Jingzhou 434008 China Laboratory of Oncology Center forMolecular Medicine Medical School Yangtze University Jingzhou 434023 China

Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery（CRS） and hyperthermic intraperitoneal chemotherapy（HIPEC） may prove to be an efficacious treatment option. In addition to reviewing the natural history of gastric cancer with peritoneal carcinomatosis, this mini-review examines literature on the efficacy of CRS and HIPEC as compared to chemotherapy and surgical options. Both randomized and nonrandomized studies were summarized with the emphasis focused on overall survival. In summary, CRS and HIPEC are indeed a promising treatment option for gastric cancer with peritoneal carcinomatosis and large randomized clinical trials are warranted.

关键词： Cytoreductive surgery hyperthermic intraperitoneal chemotherapy peritoneal carcinomatosis

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Postoperative complications and critical care management after cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: A systematic review of the literature

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World Journal of Critical Care Medicine 2022年第6期11卷 375-386页

作者： Anjana S Wajekar Sohan Lal Solanki Vijaya P Patil Department of Anaesthesiology Critical Care and PainTata Memorial HospitalHomi Bhabha National InstituteMumbai 400012MaharashtraIndia

BACKGROUND Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a comprehensive treatment option performed for peritoneal surface *** almost all patients are transferred to the intensive care unit *** To describe the common and rare postoperative complications,postoperative mortality and their critical care management after *** The authors assessed 54 articles for *** text assessment identified 14 original articles regarding postoperative complications and critical care management for inclusion into the final review *** There is an exaggerated metabolic and inflammatory response after surgery which may be termed as physiological in view of the nature of surgery combined with the use of heated intraperitoneal chemotherapy with/out early postoperative intravenous *** expected postoperative course is further ***-HIPEC is a complex procedure with some life-threatening complications in the immediate postoperative period,reported morbidity rates between 12%-60%and a mortality rate of 0.9%-5.8%.Over the years,since its inception in the 1980s,postoperative morbidity and survival have significantly *** commonest postoperative surgical complications and systemic toxicity due to chemotherapy as reported in the last decade are *** CRS-HIPEC is associated with a varying rate of postoperative complications including postoperative deaths and needs early suspicion and intensive care monitoring.

关键词： Intensive care units hyperthermic intraperitoneal chemotherapy Morbidity Peritoneal neoplasms Postoperative period

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Role of prophylactic hyperthermic intraperitoneal chemotherapy in patients with locally advanced gastric cancer

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World Journal of Gastrointestinal Oncology 2020年第7期12卷 782-790页

作者： Tian-Yu Xie Di Wu Shuo Li Zhao-Yan Qiu Qi-Ying Song Da Guan Li-Peng Wang Xiong-Guang Li Feng Duan Xin-Xin Wang School of Medicine Nankai UniversityTianjin 300071China Department of General Surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND Gastric cancer is the second most common malignant tumor in China,ranking third among all malignant tumor mortality *** intraperitoneal chemotherapy(HIPEC)has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs,prolong the action time of these drugs on intraperitoneal tumor cells,and enhance their diffusion in tumor *** may be one of the best choices for the eradication of residual cancer cells in the abdominal *** The aim of this study was to study the role of preventive HIPEC after radical *** A prospective analysis was performed with patients with c T4 N0-3 M0 gastric cancer to compare the effects of postoperative prophylactic HIPEC plus intravenous chemotherapy with those of routine adjuvant ***’medical records were analyzed,and differences in the peritoneal recurrence rate,diseasefree survival time,and total survival time between groups were *** The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group(P=0.020).The 1-year and 3-year disease-free survival rates were 91.9%and 60.4%,respectively,in the conventional adjuvant chemotherapy group and 92.1%and 63.0%,respectively,in the HIPEC *** 1-year and 3-year overall survival rates were 95.2%and 66.3%,respectively,in the conventional adjuvant chemotherapy group and 96.1%and 68.6%,respectively,in the HIPEC *** significant difference in postoperative or chemotherapy complications was observed between *** In patients with c T4 N0-3 M0 gastric cancer,prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival.

关键词： hyperthermic intraperitoneal chemotherapy Gastric cancer Prognosis Locally advanced Overall survival Disease-free survival

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