According to the study “Cytoreductive Surgery Versus Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy For Gastric Cancer with Peritoneal Metastasis (CYTO-CHIP study): A Propensity-Score Analysis from BIG-RENAPE and FREGAT Networks“, conducted by multiple authors in collaboration with FREGAT and BIG -RENAPE, good results are still obtained in the application of cytoreductive surgery combined with high temperature chemotherapy (HIPEC) in the cases of patients with gastric origin peritoneal carcinomatosis.
Cytoreductive surgery is the traditional approach to cases of metastasis in the peritoneum, and involves the removal of all surfaces affected by cancer, both in the abdominal walls and in the tissues that cover the organs. The cytoreductive surgery combined with HIPEC consists in the realization of this first removal of the tumor and then the application of hot chemotherapy (at 41 or 42 degrees) on the surface affected by the tumor. Heat has an effect that increases the penetration of the treatment into the cells.
The study focuses on the initial premise that the HIPEC technique continues to be controversial, its real benefit not being known in front of the treatment of the patient only with cytoreductive surgery, in the case of patients with gastric origin peritoneal carcinomatosis. That is why a clinical trial is carried out in 277 patients with this pathology, treated in 19 medical centers in France between 1989 and 2014.
The results show that patients treated with cytoreductive surgery together with HIPEC, in relation to those who were only treated with cytoreductive surgery, have a better mean survival of 18.8 months in relation to 12.1 months in the case of conventional surgery . The 3-year patient survival is postulated in 26.21% in the case of treatment with HIPEC vs. 19.87% in cases in which only cytoreductive surgery was applied.
Thus, according to this study, the treatment in cases of peritoneal carcinomatosis of gastric cancer origin, it is recommended to perform it through cytoreductive surgery, in which the tumor is removed, combined with HIPEC, because it offers a longer life expectancy to the patients and improves their quality of life.