EFFECTIVENESS OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY IN RESECTABLE GASTRIC CANCER pT4a-bN0-3M0
Objective. To evaluate the possibility of reducing the frequency and risk of peritoneal dissemination developing in radically operated gastric cancer patients by using intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC).
Materials and methods. The paper evaluates the results of the randomized study of treating 123 patients for IIB-IIIC stage resectable gastric cancer (Borrmann type III—IV), with 68 of them undergoing HIPEC based on the technique adopted in the clinic.
Results. Combination of radical surgery and HIPEC allowed to reduce the frequency of peritoneal dissemination by 47.3% (p<0.001) and its 3-year cumulative incidence from 67.60%±0.50% to 22.10%±0.30% (p<0.001). The expediency of using HIPEC in patients with resectable gastric cancer has been confirmed by the results of a multivariate analysis of the competing risks (the Fine—Gray regression model), indicating an increased risk of the peritoneal carcinomatosis formation in the absence of HIPEC (RR 5.0; 95% CI (2.8—8.8); p<0.001).