Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases

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• dc.contributor.author Steinhoff, Heinrich
• dc.contributor.author Acs, Miklos
• dc.contributor.author Blaj, Sebastian
• dc.contributor.author Dank, Magdolna
• dc.contributor.author Herold, Magdolna
• dc.contributor.author Herold, Zoltan
• dc.contributor.author Herzberg, Jonas
• dc.contributor.author Sánchez Velázquez, Patricia, 1985-
• dc.contributor.author Strate, Tim
• dc.contributor.author Szasz, Attila Marcell
• dc.contributor.author Piso, Pompiliu
• dc.date.accessioned 2024-04-11T14:35:20Z
• dc.date.available 2024-04-11T14:35:20Z
• dc.date.issued 2023
• dc.description.abstract Background: Advanced gastric cancer with synchronous peritoneal metastases (GC-PM) is associated with a poor prognosis. Although cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a promising approach, only a limited number of Western studies exist. Aim: To investigate the clinicopathological outcomes of patients who underwent CRS-HIPEC for GC-PM. Methods: A retrospective analysis of patients with GC-PM was conducted. All patients were seen at the Department of General and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany between January 2011 and July 2021 and underwent CRS-HIPEC. Preoperative laboratory results, the use of neoadjuvant trastuzumab, and the details of CRS-HIPEC, including peritoneal carcinomatosis index, completeness of cytoreduction, and surgical procedures were recorded. Disease-specific (DSS), and overall survival (OS) of patients were calculated. Results: A total of 73 patients were included in the study. Patients treated with neoadjuvant trastuzumab (n = 5) showed longer DSS (P = 0.0482). Higher white blood cell counts (DSS: P = 0.0433) and carcinoembryonic antigen levels (OS and DSS: P < 0.01), and lower hemoglobin (OS and DSS: P < 0.05) and serum total protein (OS: P = 0.0368) levels were associated with shorter survival. Longer HIPEC duration was associated with more advantageous median survival times [60-min (n = 59): 12.86 mo; 90-min (n = 14): 27.30 mo], but without statistical difference. To obtain additional data from this observation, further separation of the study population was performed. First, propensity score-matched patient pairs (n = 14 in each group) were created. Statistically different DSS was found between patient pairs (hazard ratio = 0.2843; 95% confidence interval: 0.1119-0.7222; P = 0.0082). Second, those patients who were treated with trastuzumab and/or had human epidermal growth factor receptor 2 positivity (median survival: 12.68 mo vs 24.02 mo), or had to undergo the procedure before 2016 (median survival: 12.68 mo vs 27.30 mo; P = 0.0493) were removed from the original study population. Conclusion: Based on our experience, CRS-HIPEC is a safe and secure method to improve the survival of advanced GC-PM patients. Prolonged HIPEC duration may serve as a good therapy for these patients.
• dc.format.mimetype application/pdf
• dc.identifier.citation Steinhoff H, Acs M, Blaj S, Dank M, Herold M, Herold Z, et al. Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases. World J Gastroenterol. 2023 May 14;29(18):2850-63. DOI: 10.3748/wjg.v29.i18.2850
• dc.identifier.doi http://dx.doi.org/10.3748/wjg.v29.i18.2850
• dc.identifier.issn 1007-9327
• dc.identifier.uri http://hdl.handle.net/10230/59741
• dc.language.iso eng
• dc.publisher Baishideng Publishing Group
• dc.relation.ispartof World J Gastroenterol. 2023 May 14;29(18):2850-63
• dc.rights © The Author(s) 2023. Published by Baishideng Publishing Group Inc. This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/Licenses/by-nc/4.0/
• dc.subject.keyword Cytoreductive surgery
• dc.subject.keyword Gastric cancer
• dc.subject.keyword Hyperthermic intraperitoneal chemotherapy
• dc.subject.keyword Peritoneal metastasis
• dc.subject.keyword Stomach neoplasms
• dc.title Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion