title: The Role of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer.
abstract: Peritoneal metastasis, either synchronous or metachronous, is commonly seen in gastric cancer. It is associated with a poor prognosis, with a median survival of less than one year. The outcomes are not significantly improved by the use of systemic chemotherapy. We review the relevant literature on the role of HIPEC in gastric cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used in three situations in gastric cancer. Besides its role as a definitive treatment in patients with established peritoneal metastasis (PM), it has been used as a prophylaxis against peritoneal recurrence after curative surgery and also as a palliative treatment in advanced peritoneal metastasis with intractable ascites. While prophylactic HIPEC has been shown to reduce peritoneal recurrence and improve survival in many randomised trials, palliative HIPEC can reduce the need for frequent paracentesis. Although CRS with HIPEC has shown promise in increasing the survival of selected patients with established PM from gastric cancer, larger studies are needed before this can be accepted as a standard of care.
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Chennai, 600036 India.
authors.forename: Ramakrishnan Ayloor
authors.initials: RA
authors.lastname: Seshadri
authors.affiliation: Department of Surgical oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, 69495 Pierre-Bénite Cedex, France ; Université Lyon 1, EMR 3738, 69600 Oullins, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Glehen
keywords: Cytoreductive surgery; Gastric cancer; Hyperthermic intraperitoneal chemotherapy; Peritoneal carcinomatosis