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Published in: BMC Cancer 1/2012

Open Access 01-12-2012 | Research article

Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials

Authors: Jingxu Sun, Yongxi Song, Zhenning Wang, Peng Gao, Xiaowan Chen, Yingying Xu, Jiwang Liang, Huimian Xu

Published in: BMC Cancer | Issue 1/2012

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Abstract

Background

In this meta-analysis we aimed to determine the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPC) for patients with advanced gastric cancer who underwent gastrectomy.

Methods

In accordance with standard meta-analysis procedures, our study included patients who underwent resection for advanced gastric cancer and were randomly allocated to receive either hyperthermic intraperitoneal chemotherapy or control. We searched PubMed (up to November 2011), EMBASE (up to November 2011), Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CCTR) (up to November 2011). Both published and unpublished trials were included in the analysis, and no search restrictions were imposed. There was no language restriction. The results were analyzed using RevMan 5.1 software, which was provided by Cochrane Collaboration.

Results

There were ten randomized controlled trials included in the analysis. A total of 1062 patients with gastric cancer in these studies were divided into the HIPC group (n = 518) and control group (n = 544). A significant improvement in survival was observed in the HIPC groups compared to the control group in the mitomycin C (MMC) subgroup (RR = 0.75, 95%CI 0.65-0.86; P < 0.00001) and the 5-FU group (RR = 0.69, 95%CI 0.52-0.90; P < 0.00001); the total RR was 0.73 (95%CI 0.64-0.83; P < 0.00001). Our findings indicated that HIPC potentially exhibited a lower peritoneal recurrence rate in the HIPC group compared to the control group (RR = 0.45, 95%CI 0.28-0.72; P = 0.001).

Conclusions

Our meta-analysis demonstrated that HIPC may improve the overall survival rate for patients who receive resection for advance gastric cancer potentially, and help to prevent peritoneal local recurrence among patients with serosal invasion in gastric cancer.
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Literature
1.
go back to reference Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Neqri E, Malvezzi M, La VC: Recent patterns in gastric cancer: A global overview. Int J Cancer. 2009, 125: 666-673. 10.1002/ijc.24290.CrossRefPubMed Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Neqri E, Malvezzi M, La VC: Recent patterns in gastric cancer: A global overview. Int J Cancer. 2009, 125: 666-673. 10.1002/ijc.24290.CrossRefPubMed
2.
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 2005, 55 (2): 74-108. 10.3322/canjclin.55.2.74.CrossRefPubMed Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 2005, 55 (2): 74-108. 10.3322/canjclin.55.2.74.CrossRefPubMed
5.
go back to reference Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J, Fontaumard E, Brachet A, Caillot JL, Faure JL, et al: Peritoneal carcinomatosis from non-gynecologic malignancies: Results of the EVOCAPE 1 multicentric prospective study. Cancer. 2000, 88: 358-363. 10.1002/(SICI)1097-0142(20000115)88:2<358::AID-CNCR16>3.0.CO;2-O.CrossRefPubMed Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J, Fontaumard E, Brachet A, Caillot JL, Faure JL, et al: Peritoneal carcinomatosis from non-gynecologic malignancies: Results of the EVOCAPE 1 multicentric prospective study. Cancer. 2000, 88: 358-363. 10.1002/(SICI)1097-0142(20000115)88:2<358::AID-CNCR16>3.0.CO;2-O.CrossRefPubMed
6.
go back to reference Roviello F, Marrelli D, Manzoni GD, Morqaqni P, Di Leo A, Saraqoni L, De Stefano A: Prospective study of peritoneal recurrence after curative surgery for gastric cancer. Br J Surg. 2003, 90: 1113-1119. 10.1002/bjs.4164.CrossRefPubMed Roviello F, Marrelli D, Manzoni GD, Morqaqni P, Di Leo A, Saraqoni L, De Stefano A: Prospective study of peritoneal recurrence after curative surgery for gastric cancer. Br J Surg. 2003, 90: 1113-1119. 10.1002/bjs.4164.CrossRefPubMed
7.
go back to reference Yamada E, Miyaishi S, Nakazato H: The surgical treatment of cancer of the stomach. Int Surg. 1980, 65: 387-399.PubMed Yamada E, Miyaishi S, Nakazato H: The surgical treatment of cancer of the stomach. Int Surg. 1980, 65: 387-399.PubMed
8.
go back to reference Yan TD, Black D, Suqarbaker PH, Zhu J, Yonemura Y, Petrou G, Morris DL: A systematic review and meta-analysis of the randomized controlled trials on adjuvant intra-peritoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol. 2007, 14: 2702-2713. 10.1245/s10434-007-9487-4.CrossRefPubMed Yan TD, Black D, Suqarbaker PH, Zhu J, Yonemura Y, Petrou G, Morris DL: A systematic review and meta-analysis of the randomized controlled trials on adjuvant intra-peritoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol. 2007, 14: 2702-2713. 10.1245/s10434-007-9487-4.CrossRefPubMed
9.
go back to reference Sugarbaker PH, Yu W, Yonemura Y: Gastrectomy, peritonectomy, and perioperative intraperitoneal chemotherapy: The evolution of treatment strategies for advanced gastric cancer. Semin Surg Oncol. 2003, 21: 233-248. 10.1002/ssu.10042.CrossRefPubMed Sugarbaker PH, Yu W, Yonemura Y: Gastrectomy, peritonectomy, and perioperative intraperitoneal chemotherapy: The evolution of treatment strategies for advanced gastric cancer. Semin Surg Oncol. 2003, 21: 233-248. 10.1002/ssu.10042.CrossRefPubMed
10.
go back to reference Xu DZ, Zhan YQ, Sun XW, Cao SM, Geng QR: Meta-analysis of intraperitoneal chemotherapy for gastric cancer. World J Gastroenterol. 2004, 10 (18): 2727-2730.CrossRefPubMedPubMedCentral Xu DZ, Zhan YQ, Sun XW, Cao SM, Geng QR: Meta-analysis of intraperitoneal chemotherapy for gastric cancer. World J Gastroenterol. 2004, 10 (18): 2727-2730.CrossRefPubMedPubMedCentral
11.
go back to reference Shiu MH, Fortner JG: Intraperitoneal hyper-thermic treatment of implanted peritoneal can-cer in rats. Cancer Res. 1980, 40: 4081-4084.PubMed Shiu MH, Fortner JG: Intraperitoneal hyper-thermic treatment of implanted peritoneal can-cer in rats. Cancer Res. 1980, 40: 4081-4084.PubMed
12.
go back to reference Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J: Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Cancer Res. 1980, 40: 256-260.PubMed Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J: Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Cancer Res. 1980, 40: 256-260.PubMed
13.
go back to reference Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996, 17: 1-12. 10.1016/0197-2456(95)00134-4.CrossRefPubMed Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996, 17: 1-12. 10.1016/0197-2456(95)00134-4.CrossRefPubMed
14.
go back to reference Cochran WG: The combination of estimates from different experiments. Biometrics. 1954, 10: 101-129. 10.2307/3001666.CrossRef Cochran WG: The combination of estimates from different experiments. Biometrics. 1954, 10: 101-129. 10.2307/3001666.CrossRef
15.
16.
go back to reference Koga S, Hamazoe R, Maeta M, Shimizu N, Murakami A, Wakatsuki T: Prophylactic cancer therapy for peritoneal recurrence of gastric by continuous hyperthermic peritoneal perfusion with Mitomycin C. Cancer. 1988, 61 (2): 232-237. 10.1002/1097-0142(19880115)61:2<232::AID-CNCR2820610205>3.0.CO;2-U.CrossRefPubMed Koga S, Hamazoe R, Maeta M, Shimizu N, Murakami A, Wakatsuki T: Prophylactic cancer therapy for peritoneal recurrence of gastric by continuous hyperthermic peritoneal perfusion with Mitomycin C. Cancer. 1988, 61 (2): 232-237. 10.1002/1097-0142(19880115)61:2<232::AID-CNCR2820610205>3.0.CO;2-U.CrossRefPubMed
17.
go back to reference Hamatoe R, Maeta M, Kaibara N: lntraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Cancer. 1994, 73 (8): 2048-2052. 10.1002/1097-0142(19940415)73:8<2048::AID-CNCR2820730806>3.0.CO;2-Q.CrossRef Hamatoe R, Maeta M, Kaibara N: lntraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Cancer. 1994, 73 (8): 2048-2052. 10.1002/1097-0142(19940415)73:8<2048::AID-CNCR2820730806>3.0.CO;2-Q.CrossRef
18.
go back to reference Fujimura T, Yonemura Y, Muraoka K, et al: Continuous hyperthermic peritoneal perfusion for the prevention of peritoneal recurrence of gastric cancer: randomized controlled study. Wrold J Surg. 1994, 18 (1): 150-155. 10.1007/BF00348209.CrossRef Fujimura T, Yonemura Y, Muraoka K, et al: Continuous hyperthermic peritoneal perfusion for the prevention of peritoneal recurrence of gastric cancer: randomized controlled study. Wrold J Surg. 1994, 18 (1): 150-155. 10.1007/BF00348209.CrossRef
19.
go back to reference Ikeguch M, Kondou A, Oka A, et al: Effects of continuous hyperthermic peritoneal perfusion on prognosis of gastric cancer with serosal invasion. Eur J Surg. 1995, 161 (8): 581-586. Ikeguch M, Kondou A, Oka A, et al: Effects of continuous hyperthermic peritoneal perfusion on prognosis of gastric cancer with serosal invasion. Eur J Surg. 1995, 161 (8): 581-586.
20.
go back to reference Fujimoto S, Takahashi M, Mutou T, Kobayashi K, Toyosawa T: Successful intra-peritoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer. 1999, 85: 529-554. 10.1002/(SICI)1097-0142(19990201)85:3<529::AID-CNCR3>3.0.CO;2-9.CrossRefPubMed Fujimoto S, Takahashi M, Mutou T, Kobayashi K, Toyosawa T: Successful intra-peritoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer. 1999, 85: 529-554. 10.1002/(SICI)1097-0142(19990201)85:3<529::AID-CNCR3>3.0.CO;2-9.CrossRefPubMed
21.
go back to reference Yonemura Y, de Aretxabala X, Fujimura T, et al: Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomised controlled study. Hepatogastroenterol. 2001, 48: 1776-1782. Yonemura Y, de Aretxabala X, Fujimura T, et al: Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomised controlled study. Hepatogastroenterol. 2001, 48: 1776-1782.
22.
go back to reference Zuo Y, Xu M, Shen D, Lu JF: Postoperative intraperitionealhyperthermic chemoperfusion combined with intravenous chemotherapy for 82 advanced gastric cancer patients. Zhonghua Zhongliu Zazhi. 2004, 26: 247-249.PubMed Zuo Y, Xu M, Shen D, Lu JF: Postoperative intraperitionealhyperthermic chemoperfusion combined with intravenous chemotherapy for 82 advanced gastric cancer patients. Zhonghua Zhongliu Zazhi. 2004, 26: 247-249.PubMed
23.
go back to reference Wei G, Fang GE, Bi JW, Shen XJ, Nie MM, Xue XC, Hua JD: Efficacy of intraoperative hypotonic peritoneal chemo-hyperthermia combined with early postoperative intraperitoneal chemotherapy on gastric cancer. Ai Zheng. 2005, 24: 478-482.PubMed Wei G, Fang GE, Bi JW, Shen XJ, Nie MM, Xue XC, Hua JD: Efficacy of intraoperative hypotonic peritoneal chemo-hyperthermia combined with early postoperative intraperitoneal chemotherapy on gastric cancer. Ai Zheng. 2005, 24: 478-482.PubMed
24.
go back to reference Zhang GY, Chen XC, Pan K, Xia LG, Zuo M, Zheng T: Application of hyperthermic intraoperitoneal chemotherapy in patients with gastric cancer. Zhonghua Wei Chang Waike Zazhi. 2007, 10 (4): 362-364. Zhang GY, Chen XC, Pan K, Xia LG, Zuo M, Zheng T: Application of hyperthermic intraoperitoneal chemotherapy in patients with gastric cancer. Zhonghua Wei Chang Waike Zazhi. 2007, 10 (4): 362-364.
25.
go back to reference Deng HJ, Wei ZG, Zhen L, Li GX, Uang XC, Qing SH: Clinical application of perioperative continuous hyperthermic peritoneal perfusion chemotherapy for gastric cancer. Nan Fang Yi Ke Da Xue Xue Bao. 2009, 29 (2): 295-297.PubMed Deng HJ, Wei ZG, Zhen L, Li GX, Uang XC, Qing SH: Clinical application of perioperative continuous hyperthermic peritoneal perfusion chemotherapy for gastric cancer. Nan Fang Yi Ke Da Xue Xue Bao. 2009, 29 (2): 295-297.PubMed
26.
go back to reference Kim JY, Bae HS: A controlled clinical study of serosa-invasive gastric carcinoma patients who underwent surgery plus intraperitoneal hyperthermo-chemo-perfusion (IHCP). Gastric Cancer. 2001, 4: 27-33. 10.1007/s101200100013.CrossRefPubMed Kim JY, Bae HS: A controlled clinical study of serosa-invasive gastric carcinoma patients who underwent surgery plus intraperitoneal hyperthermo-chemo-perfusion (IHCP). Gastric Cancer. 2001, 4: 27-33. 10.1007/s101200100013.CrossRefPubMed
27.
go back to reference Sugarbaker PH: Management of Gastric Cancer. 1991, Boston: Kluwer Academic Publisher, 277-284. Sugarbaker PH: Management of Gastric Cancer. 1991, Boston: Kluwer Academic Publisher, 277-284.
28.
go back to reference Weisberger AS, Levine B, Storaasli JP: Use of nitrogen mus-tard in treatment of serous effusions of neoplastic origin. JAMA. 1955, 159: 1704-1707. 10.1001/jama.1955.02960350004002. Weisberger AS, Levine B, Storaasli JP: Use of nitrogen mus-tard in treatment of serous effusions of neoplastic origin. JAMA. 1955, 159: 1704-1707. 10.1001/jama.1955.02960350004002.
30.
go back to reference MacDonald JS, Malley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, et al: Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001, 345: 725-729. 10.1056/NEJMoa010187.CrossRefPubMed MacDonald JS, Malley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, et al: Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001, 345: 725-729. 10.1056/NEJMoa010187.CrossRefPubMed
31.
go back to reference Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scrarffe JH, Lofts FJ, Falk SJ, Iveson TJ, et al: Perioperative chemotherapy versus surgery alone for resectable gastro-esophageal cancer. N Engl J Med. 2006, 355: 11-20. 10.1056/NEJMoa055531.CrossRefPubMed Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scrarffe JH, Lofts FJ, Falk SJ, Iveson TJ, et al: Perioperative chemotherapy versus surgery alone for resectable gastro-esophageal cancer. N Engl J Med. 2006, 355: 11-20. 10.1056/NEJMoa055531.CrossRefPubMed
32.
go back to reference Kazuo H, Kanji K, Atsushi I, Yamaquchi A, Nakaqawara G, Umeda S, Kusaka Y: Efficacy of Continuous Hyperthermic Peritoneal Perfusion for the Prophylaxis and Treatment of Peritoneal Metastasis of Advanced Gastric Cancer: Evaluation by Multivariate Regression Analysis. Oncology. 1999, 57: 106-114. 10.1159/000012016.CrossRef Kazuo H, Kanji K, Atsushi I, Yamaquchi A, Nakaqawara G, Umeda S, Kusaka Y: Efficacy of Continuous Hyperthermic Peritoneal Perfusion for the Prophylaxis and Treatment of Peritoneal Metastasis of Advanced Gastric Cancer: Evaluation by Multivariate Regression Analysis. Oncology. 1999, 57: 106-114. 10.1159/000012016.CrossRef
33.
go back to reference Sugarbaker PH: Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol. 1998, 14 (3): 254-261. 10.1002/(SICI)1098-2388(199804/05)14:3<254::AID-SSU10>3.0.CO;2-U.CrossRefPubMed Sugarbaker PH: Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol. 1998, 14 (3): 254-261. 10.1002/(SICI)1098-2388(199804/05)14:3<254::AID-SSU10>3.0.CO;2-U.CrossRefPubMed
Metadata
Title
Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials
Authors
Jingxu Sun
Yongxi Song
Zhenning Wang
Peng Gao
Xiaowan Chen
Yingying Xu
Jiwang Liang
Huimian Xu
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-12-526

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