Survival outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in selected patients with stage IV gastric adenocarcinoma – A Canadian case series

Despite advances in systemic therapy, metastatic gastric cancer is associated with a poor prognosis. As peritoneal disease is common, several studies looked at the potential benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in this context, with encouraging results. However, no Canadian...

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Published in:European journal of surgical oncology Vol. 51; no. 8; p. 110000
Main Authors: Bénard, Florence, Marcil, Stéphanie, Mack, Lloyd, Deban, Melina, Bildersheim, Michael, Bouchard-Fortier, Antoine, Osman, Yasmin, Mercier, Frédéric, Purich, Kieran, Haase, Erika, Schiller, Dan, Soucisse, Mikael, Sidéris, Lucas, Leblanc, Guy, Dubé, Pierre, Boulanger-Gobeil, Cindy, Hamilton, Trevor, Gervais, Mai-Kim
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.08.2025
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - secondary
Adenocarcinoma - therapy
Adult
Aged
Canada
Carcinomatosis
Cytoreduction
Cytoreduction Surgical Procedures
Female
Gastric cancer
HIPEC
Humans
Hyperthermic Intraperitoneal Chemotherapy
Male
Metastatic
Middle Aged
Neoplasm Staging
Peritoneal
Peritoneal Neoplasms - secondary
Peritoneal Neoplasms - therapy
Retrospective Studies
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
Survival Rate
Canada
Peritoneal
Carcinomatosis
Cytoreduction
Metastatic
HIPEC
Gastric cancer
ISSN:0748-7983, 1532-2157, 1532-2157
Online Access:Get full text
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Summary:Despite advances in systemic therapy, metastatic gastric cancer is associated with a poor prognosis. As peritoneal disease is common, several studies looked at the potential benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in this context, with encouraging results. However, no Canadian data currently exists on the subject. This study aims to report characteristics and outcomes of Canadian patients who underwent cytoreductive surgery and HIPEC (CRS-HIPEC) for gastric cancer associated with peritoneal disease or positive peritoneal cytology. This multicenter retrospective study included patients 18 years or older with gastric cancer associated with isolated peritoneal involvement who underwent CRS-HIPEC in five tertiary centers from 2016 to 2022. CRS-HIPEC was performed on 20 patients aged 34–69 years old, most of whom presented with poorly differentiated (90 %) adenocarcinoma, with synchronous peritoneal disease (95 %). Median PCI was 3 (0–13). The associated 90-day morbidity rate, defined as Clavien-Dindo grade III and above complications, was 10 %. At a mean follow-up of 23.3 months (range 4–48), 25 % of patients remained disease-free, with an estimated median overall survival of 24.2 months. CRS-HIPEC for gastric cancer can achieve longer term survival in highly selected patients with low-burden peritoneal disease or positive cytology. Ongoing randomized trials will further clarify patients’ selection criteria and benefits of this approach.
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ISSN:0748-7983
1532-2157
1532-2157
DOI:10.1016/j.ejso.2025.110000