Survival outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in selected patients with stage IV gastric adenocarcinoma – A Canadian case series

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-04-03 DOI:10.1016/j.ejso.2025.110000

Florence Bénard , Stéphanie Marcil , Lloyd Mack , Melina Deban , Michael Bildersheim , Antoine Bouchard-Fortier , Yasmin Osman , Frédéric Mercier , Kieran Purich , Erika Haase , Dan Schiller , Mikael Soucisse , Lucas Sidéris , Guy Leblanc , Pierre Dubé , Cindy Boulanger-Gobeil , Trevor Hamilton , Mai-Kim Gervais

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Abstract

Introduction

Despite advances in systemic therapy, metastatic gastric cancer is associated with a poor prognosis. As peritoneal disease is common, several studies looked at the potential benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in this context, with encouraging results. However, no Canadian data currently exists on the subject.

Materials and methods

This study aims to report characteristics and outcomes of Canadian patients who underwent cytoreductive surgery and HIPEC (CRS-HIPEC) for gastric cancer associated with peritoneal disease or positive peritoneal cytology. This multicenter retrospective study included patients 18 years or older with gastric cancer associated with isolated peritoneal involvement who underwent CRS-HIPEC in five tertiary centers from 2016 to 2022.

Results

CRS-HIPEC was performed on 20 patients aged 34–69 years old, most of whom presented with poorly differentiated (90 %) adenocarcinoma, with synchronous peritoneal disease (95 %). Median PCI was 3 (0–13). The associated 90-day morbidity rate, defined as Clavien-Dindo grade III and above complications, was 10 %. At a mean follow-up of 23.3 months (range 4–48), 25 % of patients remained disease-free, with an estimated median overall survival of 24.2 months.

Conclusion

CRS-HIPEC for gastric cancer can achieve longer term survival in highly selected patients with low-burden peritoneal disease or positive cytology. Ongoing randomized trials will further clarify patients’ selection criteria and benefits of this approach.

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筛选的IV期胃腺癌患者的细胞减少手术和腹腔内热化疗的生存结果-加拿大病例系列

尽管在全身治疗方面取得了进展，但转移性胃癌的预后较差。由于腹膜疾病是常见的，在这种情况下，一些研究着眼于热腹腔化疗（HIPEC）的潜在益处，并取得了令人鼓舞的结果。然而，加拿大目前没有这方面的数据。材料和方法本研究旨在报道加拿大胃癌合并腹膜疾病或腹膜细胞学阳性患者行细胞减缩手术和HIPEC （CRS-HIPEC）的特点和结果。这项多中心回顾性研究纳入了2016年至2022年在5个三级中心接受CRS-HIPEC治疗的18岁及以上胃癌伴孤立性腹膜受累患者。结果对20例34 ~ 69岁的患者进行了scrs - hipec检查，其中大多数为低分化腺癌（90%），同时伴有腹膜疾病（95%）。PCI中位数为3（0-13）。相关的90天发病率，定义为Clavien-Dindo III级及以上并发症，为10%。在平均23.3个月（4-48个月）的随访中，25%的患者保持无病状态，估计中位总生存期为24.2个月。结论高选择性低负担腹膜疾病或细胞学阳性的胃癌患者行crs - hipec治疗可获得较长的生存期。正在进行的随机试验将进一步阐明患者的选择标准和这种方法的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.