Summary:

• How useful is hyperthermic intraperitoneal chemotherapy (HIPEC) when given on top of cytoreductive surgery (CRS)? HIPEC gives warmed chemotherapy medicine directly to the cancer site during surgery. This study found that HIPEC increased survival compared to the group that only had surgery.

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Links:

• link.springer.com/article/10.1245/s10434-011-1631-5

Where?

• China

When?

• Published online 2011 (Annals of Surgical Oncology)

Impact Factor (IF):

• 3.930

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Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a new way to treat some types of cancer. First, surgeons cut out all of the visible cancer. Then, heated chemotherapy drugs are used to treat the area. This is done to try and kill all cancer cells and stop the disease from spreading or relapsing.

This study wanted to know if HIPEC was safe and useful for treating gastric cancer. Specifically, researchers treated patients with peritoneal carcinomatosis (PC). This means that the tumor has spread to the peritoneum from the stomach. 68 patients were randomly assigned to a treatment group. In this experiment, Group A patients had surgery (CRS) only. Group B patients had CRS and then HIPEC right after.

Chemotherapy: the medicines given in the HIPEC for Group A patients were mitomycin C and cisplatin

1. Mitomycin C: attaches to the genetic material of a cell and prevents it from dividing
2. Cisplatin: this drug stops cancer from making more cells.

First, the surgeons did a CRS procedure to take out all visible tumors in the abdomen. Next, the chemotherapy medicines were warmed and passed through the peritoneum after surgery for just over an hour.

Results: This study found that adding HIPEC to CRS increases overall survival. Average survival in Group B patients was 11.0 months. Group A patients only survived an average of 6.5 months. So, HIPEC can increase survival in patients having CRS for tumors on the peritoneum.

Additional Resources:

• hopkinsmedicine.org/surgery/about/innovations/hipec.html
  • A very helpful resource to explain CRS + HIPEC therapy and who it may help
• jamanetwork.com/journals/jamasurgery/fullarticle/396142
  • Glehen, O., et al. “Cytoreductive surgery and intraperitoneal chemohyperthermia for peritoneal carcinomatosis arising from gastric cancer.” Archives of surgery 139.1 (2004): 20-26. Available from: doi: 10.1001/archsurg.139.1.20
  • This study also looks at treating gastric cancer which has spread to the peritoneum with  CRS + HIPEC. However, this was not a randomized phase III trial, so the experiment does not directly compare two groups. It can be helpful in learning about CRS + HIPEC. These researchers found that HIPEC was helpful mostly in patients whose gastric cancer was not advanced.

Citation:

Yang, Xiao-Jun, et al. “Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial.” Annals of Surgical Oncology 18.6 (2011): 1575-1581.Available from: PMID: 9742917