Neoadjuvant Chemotherapy Followed by Cytoreductive Surgery and HIPEC Improves Survival in Peritoneal Metastatic Gastric Cancer

Abstract

Introduction: This study examined the difference in overall survival (OS) between peritoneal metastatic gastric cancer (PMGC) patients who underwent neoadjuvant chemotherapy followed by cytoreductive surgery ± hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC) and those who did not have surgery but instead received palliative chemotherapy. Methods: This retrospective study included 80 patients who were followed up with the diagnosis of PMGC, those undergoing neoadjuvant chemotherapy followed by CRS ± HIPEC (CRS ± HIPEC group) and those receiving chemotherapy only (non-surgical group), in the medical oncology clinic between April 2011 and December 2021. Clinicopathological features, treatments, and OS of the patients were compared. Results: There were 32 patients in the SRC CRS ± HIPEC group and 48 in the non-surgical group. In the CRS ± HIPEC group, CRS + HIPEC was performed on 20 patients, and only CRS was performed on 12 patients. All of the patients who underwent CRS + HIPEC, and 5 of the patients who underwent only CRS received neoadjuvant chemotherapy. While the median OS was 19.7 (15.5–23.8) months in the CRS ± HIPEC group, the median OS was 6.8 (3.5–10.2) months in the non-surgical group (p < 0.001). Conclusion: As a result, CRS + HIPEC significantly improves survival in PMGC patients. With experienced surgical centres and appropriate patient selection, the life expectancy of patients with PM can be extended.