Efficacy of Cytoreductive Surgery (CRS) + HIPEC in Gastric Cancer with Peritoneal Metastasis: Systematic Review and Meta-Analysis.

Langellotti, Lodovica; Fiorillo, Claudio; D'Annibale, Giorgio; Panza, Edoardo; Pacelli, Fabio; Alfieri, Sergio; Di Giorgio, Andrea; Santullo, Francesco

Langellotti, Lodovica; Fiorillo, Claudio; D'Annibale, Giorgio; Panza, Edoardo; Pacelli, Fabio; Alfieri, Sergio; Di Giorgio, Andrea; Santullo, Francesco.

Afiliação

Langellotti L; General Surgery Department, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Fiorillo C; Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
D'Annibale G; General Surgery Department, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Panza E; General Surgery Department, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Pacelli F; General Surgery Department, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Alfieri S; Department of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Di Giorgio A; General Surgery Department, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
Santullo F; Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Hearth, 00168 Rome, Italy.

Cancers (Basel) ; 16(10)2024 May 18.

Article em En | MEDLINE | ID: mdl-38792007

ABSTRACT

ABSTRACT

BACKGROUND:

Peritoneal carcinomatosis is one of deadliest metastatic patterns of gastric cancer, being associated with a median overall survival (OS) of 4 months. Up to now, palliative systemic chemotherapy (pSC) has been the only recommended treatment. The aim of this study is to evaluate a potential survival benefit after CRS + HIPEC compared to pSC.

METHODS:

A systematic review was conducted according to the PRISMA guidelines in March 2024. Manuscripts reporting patients with peritoneal carcinomatosis from gastric cancer treated with CRS + HIPEC were included. A meta-analysis was performed, comparing the survival results between the CRS + HIPEC and pSC groups, and the primary outcome was the comparison in terms of OS. We performed random-effects meta-analysis of odds ratios (ORs). We assessed heterogeneity using the Q2 statistic.

RESULTS:

Out of the 24 papers included, 1369 patients underwent CRS + HIPEC, with a median OS range of 9.8-28.2 months; and 103 patients underwent pSC, with a median OS range of 4.9-8 months. CRS + HIPEC was associated with significantly increased survival compared to palliative systemic chemotherapy (-1.8954 (95% CI -2.5761 to -1.2146; p < 0.001).