Evaluation of the efficacy of the combination of radical surgery,
hyperthermic intraperitoneal chemotherapy (
HIPEC), and adjuvant systemic
chemotherapy (ACT) in reducing
gastric cancer progression in patients with resectable serosa-invasive
gastric cancer in a single institution. In 2015-2016, 19 patients with
gastric cancer (stage IIB-IIIC) were included in the trial. The trial protocol comprised radical surgery,
HIPEC (
cisplatin 50 mg/m2 + doxorubicin 50 mg/m2, 42 °C, 1 hour), and 1-8 cycles of ACT (
oxaliplatin 100 mg/m2 administered on day 1 of each cycle and oral
capecitabine 1000 mg/m2 (or
tegafur 10-15 mg/kg) administered twice daily on days 1-14 of each cycle with an interval of 7 days between cycles). Following the ACT treatment, the patients were divided into 2 subgroups-those who underwent up to 6 ACT cycles (1-6 cycles, subgroup ≤ 6-8 patients) and those who underwent 7-8 ACT cycles (subgroup > 6-11 patients). Three-year
metastasis-free survival (MFS) for the > 6 subgroup was 91 ± 9%. With a follow-up median of 17 months, 3-year MFS for the ≤ 6 subgroup was not reached - p log-rank = 0.003. The trial showed that in managing advanced
gastric cancer patients (pT4a-4bN0-3 M0) by supplementing radical surgery with ACT-enhanced
hyperthermic intraperitoneal chemotherapy, ACT proved to be highly effective when administered in its full mode of 7-8 cycles compared with its truncated variant of 1-6 cycles.