|Table of Contents|

Safety analysis of radical resection combined with intraperitoneal hyperthermic perfusion chemotherapy in the treatment of patients with locally advanced gastric cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 05
Page:
869-874
Research Field:
Publishing date:

Info

Title:
Safety analysis of radical resection combined with intraperitoneal hyperthermic perfusion chemotherapy in the treatment of patients with locally advanced gastric cancer
Author(s):
CHEN Tie; JIANG Xiaohui; WU Jindong; ZHANG Xueliang; WANG Ding; LI Yangcheng
Department of Gastrointestinal Surgery,Nantong Tumor Hospital,Jiangsu Nantong 226361,China.
Keywords:
intraperitoneal hyperthermic perfusion chemotherapy; gastric cancer; radical operation; safety; lymph node dissection; nerve invasion
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2023.05.016
Abstract:
Objective:To investigate the safety of intraperitoneal hyperthermic perfusion chemotherapy in patients with locally advanced gastric cancer after radical resection.Methods:The clinical data of 146 patients with locally advanced gastric cancer who underwent D2 radical surgery combined with HIPEC in a hospital from January 2019 to December 2021 were retrospectively analyzed.Describe the occurrence of perioperative adverse events in all patients.To analyze the influencing factors of perioperative safety in patients with locally advanced gastric cancer who received D2 radical surgery combined with HIPEC.Results:Among the 146 patients,a total of 64 patients(43.84%) had 81 adverse events of varying degrees during the perioperative period,of which the number of hypoalbuminemia and anemia was the largest,with 32 cases(39.51%) and 21 cases(25.93%).Among all the adverse events,the number of grade 1 was the largest,with a total of 55 cases(37.67%).All patients with adverse events were relieved after symptomatic treatment,which did not affect the follow-up treatment.In the results of univariate analysis,there were statistically significant differences in the classification of perioperative adverse events among patients with different age and neurological invasion(P<0.05).Older than 60 years old（β'=0.651),nerve invasion of tumor（β'=0.183) patients had higher adverse event grades during perioperative period(P<0.05).Conclusion:Patients with locally advanced gastric cancer have a certain risk of adverse reactions during the perioperative period after receiving D2 radical surgery combined with HIPEC,but the incidence of various adverse reactions is still within the acceptable range.Surgeons should pay special attention to patients older than 60 years old and patients with tumor invading nerves.

References:

[1]左婷婷,郑荣寿,曾红梅,等.中国胃癌流行病学现状［J］.中国肿瘤临床,2017,44(1):52-58. ZUO Tingting,ZHENG Rongshou,ZENG Hongmei,et al.Current status of epidemiology of gastric cancer in China ［J］.China Clinical Oncology,2017,44(1):52-58.
[2]曹毛毛,李贺,孙殿钦,等.2000-2019年中国胃癌流行病学趋势分析［J］.中华消化外科杂志,2021,20(1):102-109. CAO Maomao,LI He,SUN Dianqin,et al.Analysis of the epidemiological trend of gastric cancer in China from 2000 to 2019 ［J］.Chinese Journal of Digestive Surgery,2021,20(1):102-109.
[3]林煜展.血清学指标检测在胃癌诊断中的研究进展［J］.检验医学与临床,2022,19(7):985-987. LIN Yuzhan.Research progress of serological index detection in the diagnosis of gastric cancer［J］.Laboratory Medicine and Clinical,2022,19(7):985-987.
[4]NCCN.NCCN Clinical Practice Guidelines in Oncology-Gastric Cancer（version 2.2020）［EB / OL］.Fort Washington：NCCN，2020 ［2021-10-21］.https：//www.nccn.org /professionals/physician_gls/pdf/gastric.pdf.
[5] 中国临床肿瘤学会指南工作委员会.中国临床肿瘤学会（CSCO）胃癌诊疗指南（2020.V1）［M］.北京:人民卫生出版社，2020:15-36. Guidelines Working Committee of Chinese Society of Clinical Oncology.Chinese Society of Clinical Oncology(CSCO) Guidelines for Diagnosis and Treatment of Gastric Cancer(2020.V1) ［M］.Beijing:People's Health Publishing House,2020:15-36.
[6]CUNNINGHAM D，ALLUM WH，STENNING SP，et al.Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer［J］.N Engl J Med，2006，355（1）：11-20.
[7]STICCA RP， DACH BW.Rationale for hyperthermia with intraoperative intraperitoneal chemotherapy agents ［J］.Surg Oncol Clin N Am，2003，12（3）：689-701.
[8]邵如玉,卢艳,姚德生,等.腹腔热灌注化疗治疗妇科恶性肿瘤近期疗效与安全性的临床观察［J］.临床肿瘤学杂志,2022,27(5):425-432. SHAO Ruyu,LU Yan,YAO Desheng,et al.Clinical observation of short-term efficacy and safety of intraperitoneal hyperthermic perfusion chemotherapy in the treatment of gynecological malignant tumors ［J］.Journal of Clinical Oncology,2022,27(5):425-432.
[9]SUGARBAKER PH， GRAVES T， DEBRUIJN EA， et al.Early postoperative intraperitoneal chemotherapy as an adjuvant therapy to surgery for peritoneal carcinomatosis from gastrointestinal cancer：pharmacological studies［J］.Cancer Res，1990，50（18）：5790-5794.
[10]FELDMAN AL，LIBUTTI SK，PINGPANK JF，et al.Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy［J］.J Clin Oncol，2003，21（24）：4560-4567.
[11]BONNOT PE，PIESSEN G，KEPENEKIAN V，et al.Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastases（CYTO-CHIP study）：a propensity score analysis［J］.J Clin Oncol，2019，37（23）：2028-2040.
[12]HAMAZOE R， MAETA M， KAIBARA N.Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer.Final results of a randomized controlled study［J］.Cancer，1994，73（8）：2048-2052.
[13]FUJIMOTO S， TAKAHASHI M， MUTOU T， et al.Successful intraperitoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma［J］.Cancer，1999，85（3）：529-534.
[14]IN H，SOLSKY I，PALIS B，et al.Validation of the 8th edition of the AJCC TNM staging system for gastric cancer using the national cancer database［J］.Ann Surg Oncol，2017，24（12）：3683-3691.
[15]中国抗癌协会腹膜肿瘤专业委员会，广东省抗癌协会肿瘤热疗专业委员会.中国腹腔热灌注化疗技术临床应用专家共识（2019 版）［J］.中华医学杂志，2020，100（2）：89-96. Chinese Anti-cancer Association Peritoneal Tumor Professional Committee,Guangdong Anti-cancer Association Tumor Hyperthermia Professional Committee.Expert consensus on clinical application of intraperitoneal hyperthermic chemotherapy in China(2019 edition) ［J］.Chinese Journal of Medicine,2020,100(2):89-96.
[16]NIH Department of Health and Human Services.Common terminology criteria for adverse events （CTCAE） version 5.0［R/OL］.（2017-11）［2021-05-14］.https：//ctep.cancer.gov/protocol Development/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf.
[17]YANG XJ，HUANG CQ，SUO T，et al.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer：final results of a phase III randomized clinical trial［J］.Ann Surg Oncol，2011，18（6）：1575-1581.
[18]MANZANEDO I，PEREIRA F，RIHUETE CARO C，et al.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy（HIPEC） for gastric cancer with peritoneal carcinomatosis：Multicenter study of spanish group of peritoneal oncologic surgery（GECOP）［J］.Ann Surg Oncol，2019，26（8）：2615-2621.
[19]REUTOVICH MY,KRASKO OV,SUKONKO OG.Hyperthermic intraperitoneal chemotherapy in serosa-invasive gastric cancer patients［J］.Eur J Surg Oncol，2019，45（12）：2405-2411.
[20]左云，徐敏，沈冬，等.82例进展期胃癌术后腹腔持续温热灌注联合静脉双途径化疗的临床疗效观察［J］.中华肿瘤杂志，2004，26（4）：247-249. ZUO Yun,XU Min,SHEN Dong,et al.Clinical observation of continuous intraperitoneal hyperthermic perfusion combined with intravenous dual-channel chemotherapy in 82 patients with advanced gastric cancer after surgery ［J］.Chinese Journal of Oncology,2004,26(4):247-249.
[21]BEEHARRY MK，ZHU ZL，LIU WT，et al.Prophylactic HIPEC with radical D2 gastrectomy improves survival and peritoneal recurrence rates for locally advanced gastric cancer：personal experience from a randomized case control study［J］.BMC Cancer，2019，19（1）：932.
[22]ZHU ZG， TANG R， YAN M， et al.Efficacy and safety of intraoperative peritoneal hyperthermic chemotherapy for advanced gastric cancer patients with serosal invasion.A long-term follow-up study［J］.Dig Surg，2006，23（1-2）：93-102.
[23]陈新华，罗俊，刘浩，等.腹腔热灌注化疗预防局部进展期胃癌根治术后腹膜复发的研究进展［J］.中华胃肠外科杂志，2018，21（5）：593-599. CHEN Xinhua,LUO Jun,LIU Hao,et al.Research progress of intraperitoneal hyperthermic perfusion chemotherapy to prevent peritoneal recurrence after radical resection of locally advanced gastric cancer ［J］.Chinese Journal of Gastrointestinal Surgery,2018,21(5):593-599.
[24]JAFARI MD，HALABI WJ，STAMOS MJ，et al.Surgical outcomes of hyperthermic intraperitoneal chemotherapy：analysis of the american college of surgeons national surgical quality improvement program［J］.JAMA Surg，2014，149（2）:170-175.
[25]BERGER Y,AYCART S,MANDELI JP,et al.Extreme cytoreductive surgery and hyperthermic intraperitoneal chemotherapy：Outcomes from a single tertiary center［J］.Surg Oncol，2015，24（3）：264-269.
[26]BRANDL A,YONEMURA Y,GLEHEN O,et al.Long term survival in patients with peritoneal metastasised gastric cancer treated with cytoreductive surgery and HIPEC：A multi-institutional cohort from PSOGI［J］.Eur J Surg Oncol，2021，47（1）：172-180.

Memo

Memo:
-
Last Update: 2023-01-31