Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages
Background This meta-analysis was designed to systematically assess the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery for different stages of advanced gastric cancer (AGC) during the last 12 years. Methods The Cochrane Library, PubMed, Embase, We...
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| Veröffentlicht in: | Annals of surgical oncology 2022-05, Vol.29 (5), p.3170-3186 |
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| creator | Zhang, Jian-Feng Lv, Ling Zhao, Shuai Zhou, Qian Jiang, Cheng-Gang |
| description | Background
This meta-analysis was designed to systematically assess the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery for different stages of advanced gastric cancer (AGC) during the last 12 years.
Methods
The Cochrane Library, PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched online, and papers were retrieved from other sources. Next, randomized controlled trials (RCTs) and high-quality nonrandomized controlled trials (NRCTs) were selected for this analysis. The meta-analysis was conducted with RevMan5.4 software.
Result
The 10 RCTs and 13 NRCTs selected for the study included 1892 patients. The overall survival rates were higher in the HIPEC group at 1 year (risk ratio [RR], 0.52;
P
= 0.004) and 3 years (RR, 0.63;
P
< 0.00001) than in the control group for the patients without peritoneal cancer, and the HIPEC group had a significant reduction in the recurrence rate (RR, 0.60;
p
< 0.00001). Among the patients with peritoneal carcinomatosis (PC), the HIPEC group had significantly higher overall survival rates at 1 year (RR, 0.62;
P
= 0.00001), 2 years (RR, 0.85;
P
= 0.002), and 3 years (RR, 0.87;
P
= 0.0001), with an increase in the overall median survival time of 4.67 months. The two groups showed no statistically significant difference in terms of complications for patients with PC (RR, 1.03; P = 0.93) or without PC (RR, 1.15;
P
= 0.51).
Conclusion
For local AGC without PC, standard surgery combined with prophylactic HIPEC could prolong survival and reduce the recurrence rate without more complications. The prognosis of this treatment strategy for patients with PC is closely related to patient selection. Complete cytoreduction combined with therapeutic HIPEC could prolong survival. |
| doi_str_mv | 10.1245/s10434-021-11316-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2629855536</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2629855536</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ce0faedc5bfc72e3e1309f3a00a494b51493fe043092187ff8fccab32fa3f7a93</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhiNERUvhD3BAlriUQ8AfcT64rULprlREpZYDp2jiHe-6SuKt7YDS_8X_wyGlSBw4jcfzzDv2vEnyitF3jGfyvWc0E1lKOUsZEyxP758kJ0zGqywv2dN4pnmZVjyXx8lz728pZYWg8llyLCQrZCblSfJzPR3QhT263iiyGYKDmJtgB4SO1Hvs7VyEw0TO1pur8_otqW3fmgG35IcJe3I9uh266QNZEcbTbwiOfMYA6WqAbvLGE6tJ2Md45WxvvBl25MYhhB6HQK7juIC7iWjryGr7HQYVdS_ABxdfU8-pIxDIR6M1uqUDduhfJEcaOo8vH-Jp8vXT-U29Ti-_XGzq1WWqRCFDqpBqwK2SrVYFR4FM0EoLoBSyKmslyyqhMS6RVpyVhdalVgpawTUIXUAlTpOzRffg7N2IPjTxCwq7Dga0o294zqtSSinyiL75B721o4tLmKmsqGSRVzPFF0o5671D3Ryc6cFNDaPNbGqzmNpEU5vfpjb3sen1g_TY9rh9bPnjYgTEAvhYGqIdf2f_R_YXZ6Cvrg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2647957696</pqid></control><display><type>article</type><title>Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zhang, Jian-Feng ; Lv, Ling ; Zhao, Shuai ; Zhou, Qian ; Jiang, Cheng-Gang</creator><creatorcontrib>Zhang, Jian-Feng ; Lv, Ling ; Zhao, Shuai ; Zhou, Qian ; Jiang, Cheng-Gang</creatorcontrib><description>Background
This meta-analysis was designed to systematically assess the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery for different stages of advanced gastric cancer (AGC) during the last 12 years.
Methods
The Cochrane Library, PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched online, and papers were retrieved from other sources. Next, randomized controlled trials (RCTs) and high-quality nonrandomized controlled trials (NRCTs) were selected for this analysis. The meta-analysis was conducted with RevMan5.4 software.
Result
The 10 RCTs and 13 NRCTs selected for the study included 1892 patients. The overall survival rates were higher in the HIPEC group at 1 year (risk ratio [RR], 0.52;
P
= 0.004) and 3 years (RR, 0.63;
P
< 0.00001) than in the control group for the patients without peritoneal cancer, and the HIPEC group had a significant reduction in the recurrence rate (RR, 0.60;
p
< 0.00001). Among the patients with peritoneal carcinomatosis (PC), the HIPEC group had significantly higher overall survival rates at 1 year (RR, 0.62;
P
= 0.00001), 2 years (RR, 0.85;
P
= 0.002), and 3 years (RR, 0.87;
P
= 0.0001), with an increase in the overall median survival time of 4.67 months. The two groups showed no statistically significant difference in terms of complications for patients with PC (RR, 1.03; P = 0.93) or without PC (RR, 1.15;
P
= 0.51).
Conclusion
For local AGC without PC, standard surgery combined with prophylactic HIPEC could prolong survival and reduce the recurrence rate without more complications. The prognosis of this treatment strategy for patients with PC is closely related to patient selection. Complete cytoreduction combined with therapeutic HIPEC could prolong survival.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-11316-z</identifier><identifier>PMID: 35175455</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemotherapy ; Chemotherapy, Cancer, Regional Perfusion ; Clinical trials ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Gastric cancer ; Gastrointestinal Oncology ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Medical prognosis ; Medicine ; Medicine & Public Health ; Meta-analysis ; Oncology ; Patients ; Peritoneal Neoplasms ; Peritoneum ; Statistical analysis ; Stomach Neoplasms - surgery ; Surgery ; Surgical Oncology ; Survival ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2022-05, Vol.29 (5), p.3170-3186</ispartof><rights>Society of Surgical Oncology 2022</rights><rights>2022. Society of Surgical Oncology.</rights><rights>Society of Surgical Oncology 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ce0faedc5bfc72e3e1309f3a00a494b51493fe043092187ff8fccab32fa3f7a93</citedby><cites>FETCH-LOGICAL-c375t-ce0faedc5bfc72e3e1309f3a00a494b51493fe043092187ff8fccab32fa3f7a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-11316-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-11316-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35175455$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Jian-Feng</creatorcontrib><creatorcontrib>Lv, Ling</creatorcontrib><creatorcontrib>Zhao, Shuai</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Jiang, Cheng-Gang</creatorcontrib><title>Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
This meta-analysis was designed to systematically assess the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery for different stages of advanced gastric cancer (AGC) during the last 12 years.
Methods
The Cochrane Library, PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched online, and papers were retrieved from other sources. Next, randomized controlled trials (RCTs) and high-quality nonrandomized controlled trials (NRCTs) were selected for this analysis. The meta-analysis was conducted with RevMan5.4 software.
Result
The 10 RCTs and 13 NRCTs selected for the study included 1892 patients. The overall survival rates were higher in the HIPEC group at 1 year (risk ratio [RR], 0.52;
P
= 0.004) and 3 years (RR, 0.63;
P
< 0.00001) than in the control group for the patients without peritoneal cancer, and the HIPEC group had a significant reduction in the recurrence rate (RR, 0.60;
p
< 0.00001). Among the patients with peritoneal carcinomatosis (PC), the HIPEC group had significantly higher overall survival rates at 1 year (RR, 0.62;
P
= 0.00001), 2 years (RR, 0.85;
P
= 0.002), and 3 years (RR, 0.87;
P
= 0.0001), with an increase in the overall median survival time of 4.67 months. The two groups showed no statistically significant difference in terms of complications for patients with PC (RR, 1.03; P = 0.93) or without PC (RR, 1.15;
P
= 0.51).
Conclusion
For local AGC without PC, standard surgery combined with prophylactic HIPEC could prolong survival and reduce the recurrence rate without more complications. The prognosis of this treatment strategy for patients with PC is closely related to patient selection. Complete cytoreduction combined with therapeutic HIPEC could prolong survival.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Cancer, Regional Perfusion</subject><subject>Clinical trials</subject><subject>Combined Modality Therapy</subject><subject>Cytoreduction Surgical Procedures</subject><subject>Gastric cancer</subject><subject>Gastrointestinal Oncology</subject><subject>Humans</subject><subject>Hyperthermia, Induced</subject><subject>Hyperthermic Intraperitoneal Chemotherapy</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Oncology</subject><subject>Patients</subject><subject>Peritoneal Neoplasms</subject><subject>Peritoneum</subject><subject>Statistical analysis</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1v1DAQhiNERUvhD3BAlriUQ8AfcT64rULprlREpZYDp2jiHe-6SuKt7YDS_8X_wyGlSBw4jcfzzDv2vEnyitF3jGfyvWc0E1lKOUsZEyxP758kJ0zGqywv2dN4pnmZVjyXx8lz728pZYWg8llyLCQrZCblSfJzPR3QhT263iiyGYKDmJtgB4SO1Hvs7VyEw0TO1pur8_otqW3fmgG35IcJe3I9uh266QNZEcbTbwiOfMYA6WqAbvLGE6tJ2Md45WxvvBl25MYhhB6HQK7juIC7iWjryGr7HQYVdS_ABxdfU8-pIxDIR6M1uqUDduhfJEcaOo8vH-Jp8vXT-U29Ti-_XGzq1WWqRCFDqpBqwK2SrVYFR4FM0EoLoBSyKmslyyqhMS6RVpyVhdalVgpawTUIXUAlTpOzRffg7N2IPjTxCwq7Dga0o294zqtSSinyiL75B721o4tLmKmsqGSRVzPFF0o5671D3Ryc6cFNDaPNbGqzmNpEU5vfpjb3sen1g_TY9rh9bPnjYgTEAvhYGqIdf2f_R_YXZ6Cvrg</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Zhang, Jian-Feng</creator><creator>Lv, Ling</creator><creator>Zhao, Shuai</creator><creator>Zhou, Qian</creator><creator>Jiang, Cheng-Gang</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20220501</creationdate><title>Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages</title><author>Zhang, Jian-Feng ; Lv, Ling ; Zhao, Shuai ; Zhou, Qian ; Jiang, Cheng-Gang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ce0faedc5bfc72e3e1309f3a00a494b51493fe043092187ff8fccab32fa3f7a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Cancer, Regional Perfusion</topic><topic>Clinical trials</topic><topic>Combined Modality Therapy</topic><topic>Cytoreduction Surgical Procedures</topic><topic>Gastric cancer</topic><topic>Gastrointestinal Oncology</topic><topic>Humans</topic><topic>Hyperthermia, Induced</topic><topic>Hyperthermic Intraperitoneal Chemotherapy</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Oncology</topic><topic>Patients</topic><topic>Peritoneal Neoplasms</topic><topic>Peritoneum</topic><topic>Statistical analysis</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Jian-Feng</creatorcontrib><creatorcontrib>Lv, Ling</creatorcontrib><creatorcontrib>Zhao, Shuai</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Jiang, Cheng-Gang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Jian-Feng</au><au>Lv, Ling</au><au>Zhao, Shuai</au><au>Zhou, Qian</au><au>Jiang, Cheng-Gang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>29</volume><issue>5</issue><spage>3170</spage><epage>3186</epage><pages>3170-3186</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
This meta-analysis was designed to systematically assess the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery for different stages of advanced gastric cancer (AGC) during the last 12 years.
Methods
The Cochrane Library, PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched online, and papers were retrieved from other sources. Next, randomized controlled trials (RCTs) and high-quality nonrandomized controlled trials (NRCTs) were selected for this analysis. The meta-analysis was conducted with RevMan5.4 software.
Result
The 10 RCTs and 13 NRCTs selected for the study included 1892 patients. The overall survival rates were higher in the HIPEC group at 1 year (risk ratio [RR], 0.52;
P
= 0.004) and 3 years (RR, 0.63;
P
< 0.00001) than in the control group for the patients without peritoneal cancer, and the HIPEC group had a significant reduction in the recurrence rate (RR, 0.60;
p
< 0.00001). Among the patients with peritoneal carcinomatosis (PC), the HIPEC group had significantly higher overall survival rates at 1 year (RR, 0.62;
P
= 0.00001), 2 years (RR, 0.85;
P
= 0.002), and 3 years (RR, 0.87;
P
= 0.0001), with an increase in the overall median survival time of 4.67 months. The two groups showed no statistically significant difference in terms of complications for patients with PC (RR, 1.03; P = 0.93) or without PC (RR, 1.15;
P
= 0.51).
Conclusion
For local AGC without PC, standard surgery combined with prophylactic HIPEC could prolong survival and reduce the recurrence rate without more complications. The prognosis of this treatment strategy for patients with PC is closely related to patient selection. Complete cytoreduction combined with therapeutic HIPEC could prolong survival.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35175455</pmid><doi>10.1245/s10434-021-11316-z</doi><tpages>17</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2022-05, Vol.29 (5), p.3170-3186 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Chemotherapy Chemotherapy, Cancer, Regional Perfusion Clinical trials Combined Modality Therapy Cytoreduction Surgical Procedures Gastric cancer Gastrointestinal Oncology Humans Hyperthermia, Induced Hyperthermic Intraperitoneal Chemotherapy Medical prognosis Medicine Medicine & Public Health Meta-analysis Oncology Patients Peritoneal Neoplasms Peritoneum Statistical analysis Stomach Neoplasms - surgery Surgery Surgical Oncology Survival Survival Rate |
| title | Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Combined with Surgery: A 12-Year Meta-Analysis of this Promising Treatment Strategy for Advanced Gastric Cancer at Different Stages |
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