title: Systematic review of intraperitoneal chemotherapy for gastric cancer.
abstract: BACKGROUND
  Gastric cancer with peritoneal carcinomatosis has a poor prognosis. Intraperitoneal chemotherapy has been proposed as a treatment option. This systematic review examined recent literature to determine the role of intraperitoneal chemotherapy in gastric cancer.
  
  
  METHODS
  Four electronic databases were searched between January 2004 and January 2010 for relevant studies. Defined outcomes of interest were treatment-related morbidity and mortality, long-term survival and sites of recurrence.
  
  
  RESULTS
  Fourteen studies were identified involving 914 patients with gastric cancer, of whom 819 (89·6 per cent) received intraperitoneal chemotherapy. There were two randomized controlled trials, two case-control studies and ten observational studies. Methodological quality was rated as poor in 12 studies, with selection and observer bias apparent in most non-randomized cohorts. Studies were often small and varied in terms of intraperitoneal timing of chemotherapy, chemotherapeutic agents, treatment temperature, and the use of adjuvant therapies. In the better conducted studies, survival was longer in patients receiving intraperitoneal chemotherapy and surgery than in those having surgery alone.
  
  
  CONCLUSIONS
  There is limited good-quality evidence to determine the role of intraperitoneal chemotherapy in gastric cancer. Intraperitoneal chemotherapy in gastric cancer is worthy of further appraisal. However, the quality of trials must be improved, and studies must be conducted more uniformly to minimize bias and aid comparison between centres.
authors.affiliation: Academic Department of Surgery, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, UK.
authors.forename: G
authors.initials: G
authors.lastname: Matharu
authors.forename: O
authors.initials: O
authors.lastname: Tucker
authors.forename: D
authors.initials: D
authors.lastname: Alderson
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D006801:Humans; D007274:Injections, Intraperitoneal; D007430:Intraoperative Care / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012107:Research Design / Q000592:standards; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents