title: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer.
abstract: Gastric cancer associated peritoneal carcinomatosis (GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase the survival in GCPC. Since recurrent gastric cancer remains confined to the abdominal cavity in many patients, regional therapies like aggressive cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been investigated for GCPC. HIPEC has been used for three indications in GC- as an adjuvant therapy after a curative surgery, HIPEC has been shown to improve survival and reduce peritoneal recurrences in many randomised trials in Asian countries; as a definitive treatment in established PC, HIPEC along with CRS is the only therapeutic modality that has resulted in long-term survival in select groups of patients; as a palliative treatment in advanced PC with intractable ascites, HIPEC has been shown to control ascites and reduce the need for frequent paracentesis. While the results of randomised trials of adjuvant HIPEC from western centres are awaited, the role of HIPEC in the treatment of GCPC is still evolving and needs larger studies before it is accepted as a standard of care.
authors.affiliation: Ramakrishnan Ayloor Seshadri, Department of Surgical Oncology, Cancer Institute (WIA), Chennai 600036, India.
authors.forename: Ramakrishnan Ayloor
authors.initials: RA
authors.lastname: Seshadri
authors.affiliation: Ramakrishnan Ayloor Seshadri, Department of Surgical Oncology, Cancer Institute (WIA), Chennai 600036, India.
authors.forename: Olivier
authors.initials: O
authors.lastname: Glehen
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000401:mortality; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Cytoreductive surgery; Gastric cancer; Hyperthermic intraperitoneal chemotherapy; Peritoneal carcinomatosis
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