Overall Survival Prolonged With HIPEC + Cytoreductive Surgery for Gastric Cancer

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Investigators compared data from patients with gastric cancer, examining survival rates of CRS plus HIPEC versus CRSa.
Investigators compared data from patients with gastric cancer, examining survival rates of CRS plus HIPEC versus CRSa.

Compared with cytoreductive surgery alone (CRSa), hyperthermic intraperitoneal chemotherapy (HIPEC) plus CRS prolongs overall survival (OS) among patients with gastric cancer and peritoneal carcinomatosis (PC), according to research being presented at the 2018 Gastrointestinal Cancers Symposium in San Francisco, California.

Investigators evaluated data from 277 patients with gastric cancer, 180 of whom underwent CRS plus HIPEC vs 97 who underwent CRSa. A Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW), multivariate, and sensitivity analyses was used. PC extension was measured using the Peritoneal Cancer Index (PCI).

The 2 treatment arms had similar results, though PCI remained elevated among patients in the HIPEC plus CRS arm compared with the CRSa arm (median, 6 vs 2, respectively [P =.003]).

Patients treated with HIPEC plus CRS, however, had a prolonged OS of 18.2 months vs 12.1 months among CRSa patients.

Three-year and 5-year OS rates of 26.21% and 19.87% vs 10.82% and 6.43% were noted for patients treated with HIPEC vs CRSa, respectively, (hazard ratio [HR], 1.66; 95% CI, 1.17-2.37; P = .005). Three-year and 5-year disease-free survival rates was also improved in the HIPEC arm (20.40% and 17.05% vs 5.87% and 3.76%, respectively; P =.001).

No significant differences for mortality rate, grade 3 to 4 morbidity, and surgical morbidity were observed.

The authors concluded that “this treatment, when optimal CRS can be achieved, should be considered as the gold standard since outcomes remain grim with chemotherapies.”

Reference

Bonnot PE, Piessen G, Pocard M, et al. CYTO-CHIP: cytoreductive surgery versus cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: a propensity-score analysis from BIG RENAPE and FREGAT working groups. Oral presentation at: 2018 Gastrointestinal Cancers Symposium; January 18-20, 2018; San Francisco, CA.


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