Hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric cancer with peritoneal metastasis - Joint analysis of European GASTRODATA and American national cancer database
Zuzanna Pelc , Katarzyna Sędłak , Yutaka Endo , Johanna Van Sandick , Suzanne Gisbertz , Manuel Pera , Gian Luca Baiocchi , Paolo Morgagni , Massimo Framarini , Arnulf Hoelscher , Stefan Moenig , Piotr Kołodziejczyk , Ines Gockel , Guillaume Piessen , Clarisse Eveno , Paulo Matos Da Costa , Andrew Davies , Cara Baker , William Allum , Uberto Fumagalli Romario , Karol Rawicz-Pruszyński
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引用次数: 0
Abstract
Introduction
Palliative chemotherapy is the current standard among advanced gastric cancer (GC) patients with peritoneal metastasis (PM), while the role of gastrectomy with cytoreductive surgery and HIPEC remains unclear. The current study aimed to assess treatment outcomes among GC patients with PM undergoing gastrectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) using multinational cancer registries.
Methods
The analysis (2012–2022) included stage IV GC patients with PM undergoing gastrectomy and HIPEC from the European GASTRODATA Registry (EU cohort) and the American National Cancer Database (NCDB, U.S. cohort). The study outcomes were textbook oncological outcome (TOO) assessment and overall survival (OS).
Results
Among 193 patients, 49.7 % were from the EU cohort and 50.3 % from the U.S. cohort. EU cohort had significantly higher rates of pT4 tumors (EU: 50 % vs U.S.: 40.2 %), metastatic lymph nodes (EU: 68.8 % vs U.S.: 54.6 %), and ≥16 lymph nodes evaluated (EU: 91.7 % vs U.S.: 68 %). Postoperatively, the EU cohort had longer hospital stay (EU: 53.1 % vs 22.2 %, p < 0.001), with no significant differences in 30-day readmission (EU: 14.6 % vs U.S: 7.2 %, p = 0.11) and 90-day mortality (EU: 4.2 % vs U.S.: 9.3 %, p = 0.25). TOO rates were 30.2 % and 32 % for EU and U.S. cohorts, respectively. Within the U.S. cohort, TOO achievement was associated with improved 1- (86.7 % vs. 57.4 %), 3- (55.8 % vs. 29.7 %), and 5-year OS (50.2 % vs. 29.7 %) (p = 0.0025) survival compared with non-TOO.
Conclusions
Among patients with GC and PM undergoing gastrectomy and HIPEC, achievement of TOO was associated with decreased risk of postoperative complications (EU cohort) and improved long-term survival (U.S. cohort).
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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