Abstract:
Objective To analyze the effect of optimized hyperthermic intraperitoneal chemotherapy (HIPEC) on the prevention of advanced gastric cancer recurrence and evaluate its safety.
Methods From August 2017 to November 2020, 48 patients with stage ⅡB to ⅢC advanced gastric cancer who received HIPEC after radical operation at Affiliated Hospital of Jiangnan University were included in the HIPEC group. Simultaneously, 80 patients with stage ⅡB to ⅢC gastric cancer who only received intravenous chemotherapy after radical resection were included in the control group. We compared differences in disease-free survival (DFS) and side effects between the two groups.
Results The 3-year recurrence rate was significantly lower in the HIPEC group than in the control group (37.5% vs. 72.5%, P<0.05). The median DFS was significantly lower in the control group than in the HIPEC group (17.167 vs. 25.400, P<0.05) . Multivariate Cox regression analysis showed that HIPEC was an independent protective factor against advanced gastric cancer recurrence (HR=0.465, 95%CI: 0.269-0.803, P<0.01). Furthermore, the selection of albumin paclitaxel in thermal perfusion therapy significantly reduced tumor recurrence rates (HR=0.385, 95%CI: 0.178-0.831, P=0.015). Moreover, the incidence of bone marrow suppression was lower in the HIPEC group than in the control group (HR=0.305, 95%CI: 0.136-0.682, P<0.05). However, the main acute HIPEC adverse reaction was aseptic peritonitis. Although some patients had long-term liver dysfunction, there was no statistical difference between the two groups (P>0.05).
Conclusions After radical operation, optimized HIPEC can improve the prognosis of patients with advanced gastric cancer. Consequently, the occurrence of adverse events owing to the catheterization method is controllable, which may comply with treatment needs. Moreover, using albumin paclitaxel in HIPEC appears to improve the prognosis of patients.