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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer

Conversion Surgery with HIPEC for Peritoneal Oli-gometastatic Gastric Cancer

Department of Surgical Oncology, Medical University of Lublin, 20-080 Lublin, Poland
Author to whom correspondence should be addressed.
Cancers 2019, 11(11), 1715;
Received: 27 September 2019 / Revised: 22 October 2019 / Accepted: 30 October 2019 / Published: 2 November 2019
(This article belongs to the Special Issue Recent Advances in Gastric Cancer)
Peritoneal metastases (PM) of gastric cancer (GC) are characterized by a particularly poor prognosis, with median survival time of 6 months, and virtually no 5-year survival reported. Conversion therapy for GC is defined as a surgical treatment aiming at an R0 resection after systemic chemotherapy for tumours that were originally unresectable (or marginally resectable) for technical and/or oncological reasons. The aim of the present study was to evaluate early and late outcomes in GC patients with PM who underwent the cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) after neoadjuvant (conversion) chemotherapy. Thirty patients with stage IV GC underwent CRS plus HIPEC. Severe grade III/IV (Clavien-Dindo classification) complications occurred in 13 (43%) patients. The Comprehensive Complication Index (CCI) ranged from 8.7 to 100 (median, 42.4). In the multivariate survival analysis, ypT2 and P3 (according to the Japanese classification of the PM severity) were favourable and adverse prognostic factors p = 0.031 and o = 0.035, respectively. Estimated 1- and 3-year survival was 73.9% and 36.6%, respectively. The median survival was 19.3 months. Conclusion: Conversion surgery, including extended gastrectomy and multi-organ resections followed by HIPEC performed after systemic chemotherapy therapy for GC with PM is justified in downstaged patients with ypT2 and limited (less than P3) PM. View Full-Text
Keywords: gastric cancer; peritoneal metastases; conversion therapy; CRS; HIPEC gastric cancer; peritoneal metastases; conversion therapy; CRS; HIPEC
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MDPI and ACS Style

Mielko, J.; Rawicz-Pruszyński, K.; Skórzewska, M.; Ciseł, B.; Pikuła, A.; Kwietniewska, M.; Gęca, K.; Sędłak, K.; Kurylcio, A.; Polkowski, W.P. Conversion Surgery with HIPEC for Peritoneal Oli-gometastatic Gastric Cancer. Cancers 2019, 11, 1715.

AMA Style

Mielko J, Rawicz-Pruszyński K, Skórzewska M, Ciseł B, Pikuła A, Kwietniewska M, Gęca K, Sędłak K, Kurylcio A, Polkowski WP. Conversion Surgery with HIPEC for Peritoneal Oli-gometastatic Gastric Cancer. Cancers. 2019; 11(11):1715.

Chicago/Turabian Style

Mielko, Jerzy, Karol Rawicz-Pruszyński, Magdalena Skórzewska, Bogumiła Ciseł, Agnieszka Pikuła, Magdalena Kwietniewska, Katarzyna Gęca, Katarzyna Sędłak, Andrzej Kurylcio, and Wojciech P. Polkowski 2019. "Conversion Surgery with HIPEC for Peritoneal Oli-gometastatic Gastric Cancer" Cancers 11, no. 11: 1715.

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