Efficacy and safety of intraperitoneal chemotherapy in patients with advanced gastric cancer: a cumulative meta-analysis of randomized controlled trials.

Zheng He,Xing-Yu Liu,Yong-Xi Song,Song-Cheng Yin,Zhong-Ran Ni,Ting-Ting Zhao,Zhi-Feng Miao,Ying-Ying Xu,Hui-Mian Xu,Hao Xu,Zhen-Ning Wang

doi:10.18632/oncotarget.20818

Abstract

Even when a curative gastrectomy is conducted, the majority of advanced gastric cancer patients with invasion die due to peritoneal recurrence. We performed electronic searches to identify randomized controlled trials published through April 2017 evaluating the effect of intraperitoneal chemotherapy (IPC) on survival rates. We included 23 trials reporting data on 2,767 patients with advanced gastric cancer. Overall, we noted that patients who received IPC had a significantly increased 1-year survival rate, and the treatment effect of IPC on 1-year survival was most prominent in studies conducted in Japan or those with a mean age of less than 60 years. IPC was also associated with an increased incidence of 2-year survival rate, but it was not seen to have this effect in studies conducted in China or Australia or with a mean age greater than 60 years. Similarly, IPC associated with a significantly increased 3-year survival rate, but this difference was not detected in studies conducted in Austria or with a mean age greater than 60 years. IPC has no significant effect on the 5-year survival rate. Finally, IPC was associated with a lower risk of recurrence in patients with advanced gastric cancer. The findings of this study suggest that gastric cancer patients who receive IPC associate with increased 1-year, 2-year, and 3-year survival rates, but this does not extend out to a 5-year survival rate. IPC is also shown to play a protective role against the risk of recurrence in patients with advanced gastric cancer.

Highlights

Gastric cancer is the fourth most common digestive cancer and the second leading cause of cancer-related deaths around the world [1, 2]
The findings of this study suggest that gastric cancer patients who receive intraperitoneal chemotherapy (IPC) associate with increased 1-year, 2-year, and 3-year survival rates, but this does not extend out to a 5-year survival rate
The findings suggested that IPC was associated with an increased incidence of 1-year, 2-year, and 3-year survival rate, while it had little or no significant effect on the incidence of 5-year survival rate

Summary

Introduction

Gastric cancer is the fourth most common digestive cancer and the second leading cause of cancer-related deaths around the world [1, 2]. Surgery is usually combined with systemic perioperative chemotherapy, which has demonstrated benefits of significantly increasing survival rate at different followup durations than in patients who received surgery alone [3, 4]. Even in patients who received systemic chemotherapy, peritoneal dissemination is a major cause www.impactjournals.com/oncotarget of gastric cancer recurrence due to tumor-cell spillage in perioperative period or during surgery [5]. Previous trials have demonstrated the treatment effect of intraperitoneal chemotherapy (IPC) of colorectal origin, including for pseudomyxoma and mesothelioma [6,7,8]. Clarifying any potential treatment effect of IPC in patients with advanced gastric cancer is important, as it has not been definitively determined. The treatment effect of IPC was compared among patients with different characteristics

Methods

Results

Conclusion