Title:
Outcomes of Locally Advanced Gastric Cancer Treated with D2 Gastrectomy and HIPEC

Authors:
Tentes A. A., Kyziridis D., Kalakonas A., Karanikiotis H., Greece

Abstract:

Background-Aims:

D₂ gastrectomy followed by adjuvant chemotherapy is considered the potentially curative treatment for locally advanced gastric cancer. The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising adjuvant treatment intending to reduce the incidence of loco-regional recurrences. The aim of the study is to evaluate the effect of HIPEC in locally advanced gastric cancer by comparing patients who underwent D₂ gastrectomy and HIPEC (HIPEC group) with D₂ gastrectomy alone (CON group).

Methods:

Overall survival, morbidity, in-hospital mortality, and recurrence were correlated to clinical and histopathological variables.

Results:

Overall survival in HIPEC and CON group was 68% and 48% respectively but the difference was not statistically significant (p=0.091). The groups were similar for in-hospital mortality although the morbidity rate was higher in HIPEC group (p=0.032). The recurrence rate was similar in both groups even though the rate of locoregional recurrence in CON group was considerably higher (p=0.003).

Conclusions:

HIPEC may safely be used as an adjuvant in gastric cancer despite the higher risk of complications although it is not an independent indicator of morbidity. HIPEC does not increase the in-hospital mortality and the rate of distant metastases; it appears to reduce the rate of loco-regional recurrence. Further studies are required to investigate the role of HIPEC in locally advanced gastric cancer.

DOI: http://dx.doi.org/10.51505/ijmshr.2025.9104