title: Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat gastric cancer with ascites and/or peritoneal carcinomatosis: Results from a Chinese center.
abstract: BACKGROUND
  This work was to evaluate cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced gastric cancer (GC).
  
  
  METHODS
  CRS and HIPEC were performed on 28 GC patients with peritoneal carcinomatosis (PC) and/or malignant ascites, with survival and perioperative safety as study endpoints.
  
  
  RESULTS
  A total of 30 CRS and HIPEC procedures were performed. Cytoreduction scores ratings (CCR) were CCR-0 in 11 (39.2%), CCR-1 in 6 (21.4%), CCR-2 in 8 (28.8%), and CCR-3 in 3 (10.6%) cases. The 6-, 12-, 18-, and 24-month survival rates were 75%, 50%, 43%, and 43%, respectively. The median survivals of patients with PCI <or=20 and high PCI >20 were 27.7 months (95% CI 15.2-40.3 months) and 6.4 months (95% CI 3.8-8.9 months) (P = 0.000). The estimated median survival for patients with CCR-0, CCR-1, and CCR-2 and 3 were 43.4 months (95% CI, 26.9-59.9 months), 9.5 months (95% CI 6.4-12.6 months), and 7.5 months (95% CI 3.0-13.6 months) (P = 0.001, CCR0 vs. CCR1-3). No perioperative death but 1 (3.6%) serious adverse event occurred.
  
  
  CONCLUSIONS
  CRS plus HIPEC could offer survival advantage for selected GC patients with PC and/or ascites, with acceptable safety profile.
authors.affiliation: Department of Oncology, Zhongnan Hospital Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuchang District, Wuhan, Hubei Province, China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001201:Ascites / Q000150:complications*; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006979:Hyperthermia, Induced; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000556:secondary*; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate