Abstract
To investigate the safety and efficacy of intraoperative intraperitoneal chemotherapy in treating advanced gastric cancer. A randomized controlled trial (RCT) of gastric cancer surgery combined with intraoperative intraperitoneal chemotherapy for the efficacy and safety were screened by computer search PubMed, Medline, Springer, Elsevier Science Direct, Weipu, Wanfang and China National Knowledge Infrastructure (CNKI) with the last report up to October 2019. The control group underwent radical gastrectomy, and the experimental group underwent intraoperative intraperitoneal chemotherapy and radical gastrectomy. A total of 997 (Experimental group 453; Control group 544) participants were considered in this meta-analysis. Compared with the control group, the experimental group has higher 1-year survival rate [OR=2.40, 95%CI (1.34, 4.33), P=0.003], 2-year survival rate [OR=3.45, 95%CI (2.08, 5.75), P<0.00001], 3-year survival rate [OR=2.70, 95%CI (2.05, 3.54), P<0.00001] and 5-year survival rate [OR=2.90, 95%CI (1.93, 4.37), P<0.00001]. There is no significant difference in postoperative bleeding (P=0.95), postoperative infection (P=0.26), postoperative anastomotic leakage (P=0.41), and postoperative intestinal obstruction (P=0.11). Intraoperative intraperitoneal chemotherapy with advanced gastric cancer in the Chinese population can improve patients’ survival rate after surgery and does not increase the incidence of postoperative complications, so it is clinically significant and safe.
Highlights
According to the 2018 Global Cancer Report (Bray et al, 2018), there are 103,370 new cases and 782,685 deaths in 2018, ranking second and third in global morbidity and mortality, and the burden of disease is heavy
24 studies were left for full publication review; of these, 13 were excluded
Our results showed that compared with the control group, the experimental group has higher 1-year survival rate [outcomes as risk ratios (ORs)=2.40, 95%CI (1.34, 4.33), P=0.003], 2-year survival rate [OR=3.45, 95%CI (2.08, 5.75), P
Summary
According to the 2018 Global Cancer Report (Bray et al, 2018), there are 103,370 new cases and 782,685 deaths in 2018, ranking second and third in global morbidity and mortality, and the burden of disease is heavy. The incidence of gastric cancer usually has no obvious symptoms and signs (Zhang et al, 2019). The detection rate of early gastric cancer is deficient, generally with no apparent symptoms. Most patients have developed advanced gastric cancer when they have symptoms (Wu et al, 2018; Xu et al, 2019). About 30% of patients have signs of local spread at the time of diagnosis, and another 30% have metastases at the time of diagnosis of gastric cancer. Radical resection is the primary means of treatment of gastric cancer. The peritoneum in the human body is one of the most common sites of recurrence of gastric cancer, and the prognosis after surgery is very poor (Zhu et al, 2019)
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