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Efficacy of Adjuvant Systemic Chemotherapy Combined with Radical Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer Treatment

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Abstract

Evaluation of the efficacy of the combination of radical surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and adjuvant systemic chemotherapy (ACT) in reducing gastric cancer progression in patients with resectable serosa-invasive gastric cancer in a single institution. In 2015–2016, 19 patients with gastric cancer (stage IIB-IIIC) were included in the trial. The trial protocol comprised radical surgery, HIPEC (cisplatin 50 mg/m2 + doxorubicin 50 mg/m2, 42 °C, 1 hour), and 1–8 cycles of ACT (oxaliplatin 100 mg/m2 administered on day 1 of each cycle and oral capecitabine 1000 mg/m2 (or tegafur 10–15 mg/kg) administered twice daily on days 1–14 of each cycle with an interval of 7 days between cycles). Following the ACT treatment, the patients were divided into 2 subgroups—those who underwent up to 6 ACT cycles (1–6 cycles, subgroup ≤ 6–8 patients) and those who underwent 7–8 ACT cycles (subgroup > 6–11 patients). Three-year metastasis-free survival (MFS) for the > 6 subgroup was 91 ± 9%. With a follow-up median of 17 months, 3-year MFS for the ≤ 6 subgroup was not reached − plog-rank = 0.003. The trial showed that in managing advanced gastric cancer patients (pT4a-4bN0-3 M0) by supplementing radical surgery with ACT-enhanced hyperthermic intraperitoneal chemotherapy, ACT proved to be highly effective when administered in its full mode of 7–8 cycles compared with its truncated variant of 1–6 cycles.

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Acknowledgments

The authors thank all patients, coordinators, and investigators who participated in the study.

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Authors and Affiliations

  1. Gastroesophageal Pathology Department, N.N. Alexandrov National Cancer Center of Belarus, Lesnoy, 223040, Minsk Region, Republic of Belarus

    M. Yu. Reutovich

  2. United Institute of Informatics Problems of the National Academy of Sciences of Belarus, 6, Surganov Str., 220012, Minsk, Republic of Belarus

    O. V. Krasko

  3. N.N. Alexandrov National Cancer Center of Belarus, Lesnoy, 223040, Minsk Region, Republic of Belarus

    O. G. Sukonko

Authors
  1. M. Yu. Reutovich
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  2. O. V. Krasko
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  3. O. G. Sukonko
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Correspondence to M. Yu. Reutovich.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Reutovich, M.Y., Krasko, O.V. & Sukonko, O.G. Efficacy of Adjuvant Systemic Chemotherapy Combined with Radical Surgery and Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer Treatment. Indian J Surg Oncol 11, 337–343 (2020). https://doi.org/10.1007/s13193-020-01102-w

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  • DOI: https://doi.org/10.1007/s13193-020-01102-w

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