Objective:To evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of gastric cancer with peritoneal carcinomatosis.Methods:The relevant clinical controlled studies were ...Objective:To evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of gastric cancer with peritoneal carcinomatosis.Methods:The relevant clinical controlled studies were retrieved from the databases of PubMed,Cochrane Library,Embase.Risk ratio(RR),as well as the respective 95%confidence interval(CI),was used as a statistical indicator.1-year survival,2-year survival,and safety were analyzed.Results:Two randomized controlled trials(RCTs)and 10 high-quality non-randomized controlled trials(NRCTs)were included,enrolling 837 patients(438 in the HIPEC group and 415 in the control group).Compared with the control group,HIPEC group turned out to be of greater improvement in long-term efficacy:1-year survival rate(1y-os)and 2-year survival rate(2y-os).Subgroup analysis of different treatment modes in NRCTs showed that,in terms of 1-year survival rate,(1)HIPEC combined with cytoreductive surgery(CRS)compared with CRS alone,RR=0.68,95%CI:(0.53,0.85);(2)HIPEC combined with intravenous chemotherapy±CRS versus chemotherapy alone,RR=0.54,95%CI:(0.39,0.74);(3)HIPEC combined with palliative gastrectomy versus palliative gastrectomy,RR=0.37,95%CI:(0.22,0.63).As for safety,there were no significant differences in adverse events between two groups.Conclusion:HIPEC can prolong the survival of gastric cancer patients with peritoneal carcinomatosis,and the incidences of adverse events were not increased.展开更多
The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%...The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.展开更多
文摘Objective:To evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy(HIPEC)in the treatment of gastric cancer with peritoneal carcinomatosis.Methods:The relevant clinical controlled studies were retrieved from the databases of PubMed,Cochrane Library,Embase.Risk ratio(RR),as well as the respective 95%confidence interval(CI),was used as a statistical indicator.1-year survival,2-year survival,and safety were analyzed.Results:Two randomized controlled trials(RCTs)and 10 high-quality non-randomized controlled trials(NRCTs)were included,enrolling 837 patients(438 in the HIPEC group and 415 in the control group).Compared with the control group,HIPEC group turned out to be of greater improvement in long-term efficacy:1-year survival rate(1y-os)and 2-year survival rate(2y-os).Subgroup analysis of different treatment modes in NRCTs showed that,in terms of 1-year survival rate,(1)HIPEC combined with cytoreductive surgery(CRS)compared with CRS alone,RR=0.68,95%CI:(0.53,0.85);(2)HIPEC combined with intravenous chemotherapy±CRS versus chemotherapy alone,RR=0.54,95%CI:(0.39,0.74);(3)HIPEC combined with palliative gastrectomy versus palliative gastrectomy,RR=0.37,95%CI:(0.22,0.63).As for safety,there were no significant differences in adverse events between two groups.Conclusion:HIPEC can prolong the survival of gastric cancer patients with peritoneal carcinomatosis,and the incidences of adverse events were not increased.
文摘The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.
