We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Efficacy of Cytoreductive Surgery (CRS) + HIPEC in Gastric Cancer with Peritoneal Metastasis: Systematic Review and Meta-Analysis.
- Authors
Langellotti, Lodovica; Fiorillo, Claudio; D'Annibale, Giorgio; Panza, Edoardo; Pacelli, Fabio; Alfieri, Sergio; Di Giorgio, Andrea; Santullo, Francesco
- Abstract
Simple Summary: Peritoneal disease in gastric cancer has a poor prognosis, with a median survival of 3–6 months and a 5-year survival rate of 0%. Despite multiple advancements in therapeutics, the National Comprehensive Cancer Network (NCCN) guidelines recommend systemic chemotherapy or best supportive care for GC with peritoneal dissemination. According to several studies, CRS + HIPEC could provide survival advantages in gastric cancer peritoneal metastasis compared to pSC. Background: Peritoneal carcinomatosis is one of deadliest metastatic patterns of gastric cancer, being associated with a median overall survival (OS) of 4 months. Up to now, palliative systemic chemotherapy (pSC) has been the only recommended treatment. The aim of this study is to evaluate a potential survival benefit after CRS + HIPEC compared to pSC. Methods: A systematic review was conducted according to the PRISMA guidelines in March 2024. Manuscripts reporting patients with peritoneal carcinomatosis from gastric cancer treated with CRS + HIPEC were included. A meta-analysis was performed, comparing the survival results between the CRS + HIPEC and pSC groups, and the primary outcome was the comparison in terms of OS. We performed random-effects meta-analysis of odds ratios (ORs). We assessed heterogeneity using the Q2 statistic. Results: Out of the 24 papers included, 1369 patients underwent CRS + HIPEC, with a median OS range of 9.8–28.2 months; and 103 patients underwent pSC, with a median OS range of 4.9–8 months. CRS + HIPEC was associated with significantly increased survival compared to palliative systemic chemotherapy (−1.8954 (95% CI: −2.5761 to −1.2146; p < 0.001). Conclusions: CRS + HIPEC could provide survival advantages in gastric cancer peritoneal metastasis compared to pSC.
- Subjects
STOMACH tumors; PERITONEUM; THERMOTHERAPY; CYTOREDUCTIVE surgery; TREATMENT effectiveness; META-analysis; DESCRIPTIVE statistics; METASTASIS; ADJUVANT chemotherapy; SYSTEMATIC reviews; MEDLINE; DRUG efficacy; ONLINE information services; COMPARATIVE studies
- Publication
Cancers, 2024, Vol 16, Issue 10, p1929
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16101929