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02-03-2024 | Gastric Cancer | Peritoneal Surface Malignancy

Initial Experience Using Laparoscopic HIPEC for Gastric Cancer with Peritoneal Metastasis: Safety and Outcomes

Authors: Meagan D. Read, MD, Justin Drake, MD, Ghazal Hashemipour, BS, Benjamin D. Powers, MS, MD, Rutika Mehta, MPH, MD, Andrew Sinnamon, MD, MSCE, Jose M. Pimiento, MD, Sean P. Dineen, MD, MHPE

Published in: Annals of Surgical Oncology | Issue 6/2024

Abstract

Background

Peritoneal metastases (PM) develop in approximately 20% of patients with gastric cancer (GC). For selected patients, treatment of PM with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising results. This report aims to describe the safety and perioperative outcomes of laparoscopic HIPEC for GC/PM.

Methods

This retrospective cohort study evaluated patients who had GC and PM treated with laparoscopic HIPEC (2018–2022). The HIPEC involved cisplatin and mitomycin C (MMC) or MMC alone. The primary end point was perioperative safety.

Results

The 22 patients in this study underwent 27 procedures. The mean age was 58 ± 13 years. All the patients were Eastern Cooperative Oncology Group (ECOG) 0 or 1 (55 and 45%, respectively). Five patients underwent a second laparoscopic HIPEC, with a median of 126 days (interquartile range [IQR], 117–166 days) between procedures. The median peritoneal carcinomatosis index (PCI) was 4 (IQR, 2–9), and the median hospital stay was 2 days (IQR, 1–3 days). No 30-day readmissions or complications occurred. Eight patients (36%) underwent gastrectomy (CRS ± HIPEC). After an average follow-up period of 11 months, 7 (32%) of the 22 patients were alive. The median overall survival was 11 months (IQR, 195–739 days) from the initial procedure and 19.3 months (IQR, 431–1204 days) from the diagnosis.

Conclusions

Laparoscopic HIPEC appears to be safe with minimal perioperative complications. Approximately one third of the patients undergoing initial laparoscopic HIPEC ultimately proceeded to cytoreduction and gastrectomy. Preliminary survival data from this highly selected cohort suggest that the addition of laparoscopic HIPEC to systemic chemotherapy does not compromise other treatment options. These initial results suggest that laparoscopic HIPEC may offer benefit to patients with GC and PM and aid in the selection of patients who may benefit from curative-intent resection.

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Title: Initial Experience Using Laparoscopic HIPEC for Gastric Cancer with Peritoneal Metastasis: Safety and Outcomes
Authors: Meagan D. Read, MD
Justin Drake, MD
Ghazal Hashemipour, BS
Benjamin D. Powers, MS, MD
Rutika Mehta, MPH, MD
Andrew Sinnamon, MD, MSCE
Jose M. Pimiento, MD
Sean P. Dineen, MD, MHPE
Publication date: 02-03-2024
Publisher: Springer International Publishing
Keywords: Gastric Cancer
Gastric Cancer
Ascites
Metastasis
Peritoneal Cancer
Peritoneal Carcinomatosis
Systemic Therapy
Gastrectomy
Gastrectomy
Cytostatic Therapy
Published in: Annals of Surgical Oncology / Issue 6/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-15102-5

At a glance: The STEP trials

Springer Medicine

Initial Experience Using Laparoscopic HIPEC for Gastric Cancer with Peritoneal Metastasis: Safety and Outcomes

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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