Hyperthermic Intraperitoneal Chemotherapy in the Management of Gastric Cancer: A Narrative Review

Int J Environ Res Public Health. 2022 Jan 7;19(2):681. doi: 10.3390/ijerph19020681.

Abstract

Gastric cancer (GC) patients with peritoneal metastasis tend to achieve poor clinical outcomes. Until recently, the treatment options were limited mainly to either palliative chemotherapy or radiation therapy in exceptional cases. Currently, these patients benefit from multimodal treatment, such as cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Despite good overall results, this treatment modality is still widely debated. The following study is designed to assess the papers about the possible application and utility of HIPEC in GC. A search in the PubMed, Web of Science, and Scopus databases was performed to assess the papers devoted to the role of HIPEC in GC treatment; a literature search was performed until March 21st; and, finally, 50 studies with a total number of 3946 patients were analyzed. According to the most recent data, it seems to be reasonable to limit the duration of HIPEC to the shortest effective time. Moreover, the drugs used in HIPEC need to have equal concentrations and the same solvent. Perioperative chemotherapy needs to be reported in detail and, furthermore, the term "morbidity" should be defined more clearly by the authors.

Keywords: cancer treatment; cytoreductive surgery; gastric cancer; hyperthermic intraperitoneal chemotherapy; peritoneal metastasis.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures / methods
  • Humans
  • Hyperthermia, Induced* / methods
  • Hyperthermic Intraperitoneal Chemotherapy
  • Peritoneal Neoplasms* / drug therapy
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / pathology