Neoadjuvant Chemotherapy Followed by Cytoreductive Surgery and HIPEC Improves Survival in Peritoneal Metastatic Gastric Cancer

Introduction: This study examined the difference in overall survival (OS) between peritoneal metastatic gastric cancer patients who underwent neoadjuvant chemotherapy followed by cytoreductive surgery +/- hyperthermic intraperitoneal chemotherapy (CRS +/- HIPEC) and those who did not have surgery but instead received palliative chemotherapy.Methods:This retrospective study included 80 patients who were followed up with the diagnosis of peritoneal metastatic gastric cancer, those undergoing neoadjuvant chemotherapy followed by CRS +/- HIPEC (CRS +/- HIPEC group) and those receiving chemotherapy only (non-surgical group), in the medical oncology clinic between April 2011 and December 2021. Clinicopathological features, treatments and OS of the patients were compared.Results:There were 32 patients in the SRC CRS +/- HIPEC group and 48 in the non-surgical group. In the CRS +/- HIPEC group, CRS+HIPEC was performed in 20 patients and only CRS was performed on 12 patients. All of the patients who underwent CRS+HIPEC, and 5 of the patients who underwent only CRS received neoadjuvant chemotherapy. While the median OS was 19.7 (15.5-23.8) months in the CRS +/- HIPEC group, the median OS was 6.8 (3.5-10.2) months in the non-surgical group (p<0.001). Conclusion:As a result, CRS+HIPEC significantly improves survival in PMGC patients. With experienced surgical centres and appropriate patient selection, the life expectancy of patients with PM can be extended.