Perioperative intraperitoneal chemotherapy for advanced gastric cancer

Background-Aims: Perioperative intraperitoneal chemotherapy either under normothermia during the early postoperative period (EPIC) or intraoperatively combined with heat (HIPEC) has been shown to improve survival after radical resection of advanced gastric cancer. The purpose of the study is to compare the effect of EPIC and HIPEC in patients undergoing D2 gastrectomy for advanced gastric cancer. Patients-Methods: Patients that received EPIC after D2 gastrectomy were retrospectively compared to those that received HIPEC after D2 gastrectomy. The end point of the study was the assessment of survival, and recurrences. Results: The groups were comparable for age, gender, performance status, tumor anatomic distribution, stage, degree of differentiation, Lauren classification, hospital mortality, morbidity, and type of surgery. 5-year survival rate for HIPEC group was 68% and for EPIC group was 14% (p=0.0054).The recurrence rate in EPIC group was 57.9% and in HIPEC group 17.4% (p=0.001). Conclusions: Patients with advanced gastric cancer undergoing D2 gastrectomy in combination with HIPEC have improved survival and lower recurrence rate as compared to those undergoing D2 gastrectomy in combination with EPIC.