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Progress in prophylatic hyperthermic intraperitoneal chemotherapy for advanced gastric carcinoma / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery ; (12): 593-599, 2018.
Article in Chinese | WPRIM | ID: wpr-689646
ABSTRACT
Advanced gastric cancer (AGC) has a high recurrence rate (especially peritoneal relapse) and a poor prognosis. Systematic chemotherapy or targeted therapy have not been able to significantly reduce the major cause of an unfavorable prognosis, namely the high peritoneal AGC recurrence rate post-surgery. Further studies concerning the application of hyperthermic intraperitoneal chemotherapy (HIPEC) post curative surgery for AGC patients, namely the prophylactic HIPEC (P-HIPEC), have involved a prophylactic approach to prevent peritoneal relapse following curative gastrectomy in high-risk patients. Theoretically, breaking the "plasma-peritoneal barrier" increases cytotoxic chemotherapy activity via a synergistic hyperthermic effect; therefore, HIPEC can eradicate free cancer cells and micro-metastasis within the peritoneal cavity intraoperatively or soon after curative gastrectomy to reduce peritoneal recurrence. Many clinical trials have shown that P-HIPEC can reduce peritoneal recurrence and improve prognosis of AGC patients. However, some studies applying HIPEC at an early stage have revealed a high rate of complications that limited generalizability. This procedure has been increasingly adopted, given the complication rate has now been reduced and safety has been proven. Recently, for assessing the important role of HIPEC, many high-quality prospective randomized controlled clinical trials have been conducted to further investigate the best guidance for P-HIPEC and to demonstrate its effectiveness and safety with a higher grade of evidence. With theory development, the technique, equipment, and management of HIPEC and the role of P-HIPEC for AGC continues to evolve. This study summarizes the progress of P-HIPEC for high-risk AGC patients.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Peritoneal Neoplasms / Stomach Neoplasms / Chemotherapy, Cancer, Regional Perfusion / Antineoplastic Combined Chemotherapy Protocols / Randomized Controlled Trials as Topic / Combined Modality Therapy / Therapeutic Uses / Drug Therapy / Hyperthermia, Induced / Neoplasm Recurrence, Local Type of study: Controlled clinical trial / Practice guideline Limits: Humans Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Peritoneal Neoplasms / Stomach Neoplasms / Chemotherapy, Cancer, Regional Perfusion / Antineoplastic Combined Chemotherapy Protocols / Randomized Controlled Trials as Topic / Combined Modality Therapy / Therapeutic Uses / Drug Therapy / Hyperthermia, Induced / Neoplasm Recurrence, Local Type of study: Controlled clinical trial / Practice guideline Limits: Humans Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2018 Type: Article