期刊论文详细信息
BMC Cancer
Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials
Jingxu Sun1  Yongxi Song1  Zhenning Wang1  Peng Gao1  Xiaowan Chen1  Yingying Xu1  Jiwang Liang1  Huimian Xu1 
[1] Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang 110001, China
关键词: Meta-analysis;    Peritoneal recurrence;    Gastric cancer;    Hyperthermic intraperitoneal chemotherapy;   
Others  :  1080085
DOI  :  10.1186/1471-2407-12-526
 received in 2012-05-26, accepted in 2012-11-12,  发布年份 2012
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【 摘 要 】

Background

In this meta-analysis we aimed to determine the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPC) for patients with advanced gastric cancer who underwent gastrectomy.

Methods

In accordance with standard meta-analysis procedures, our study included patients who underwent resection for advanced gastric cancer and were randomly allocated to receive either hyperthermic intraperitoneal chemotherapy or control. We searched PubMed (up to November 2011), EMBASE (up to November 2011), Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CCTR) (up to November 2011). Both published and unpublished trials were included in the analysis, and no search restrictions were imposed. There was no language restriction. The results were analyzed using RevMan 5.1 software, which was provided by Cochrane Collaboration.

Results

There were ten randomized controlled trials included in the analysis. A total of 1062 patients with gastric cancer in these studies were divided into the HIPC group (n = 518) and control group (n = 544). A significant improvement in survival was observed in the HIPC groups compared to the control group in the mitomycin C (MMC) subgroup (RR = 0.75, 95%CI 0.65-0.86; P < 0.00001) and the 5-FU group (RR = 0.69, 95%CI 0.52-0.90; P < 0.00001); the total RR was 0.73 (95%CI 0.64-0.83; P < 0.00001). Our findings indicated that HIPC potentially exhibited a lower peritoneal recurrence rate in the HIPC group compared to the control group (RR = 0.45, 95%CI 0.28-0.72; P = 0.001).

Conclusions

Our meta-analysis demonstrated that HIPC may improve the overall survival rate for patients who receive resection for advance gastric cancer potentially, and help to prevent peritoneal local recurrence among patients with serosal invasion in gastric cancer.

【 授权许可】

   
2012 Sun et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Neqri E, Malvezzi M, La VC: Recent patterns in gastric cancer: A global overview. Int J Cancer 2009, 125:666-673.
  • [2]Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin 2005, 55(2):74-108.
  • [3]Crew KD, Neugut AI: Epidemiology of gastric cancer. World J Gastroenterol 2006, 12(3):354-362.
  • [4]Hartgrink HH, Jansen EP, van Grieken NC, van de Velde CJ: Gastric cancer. Lancet 2009, 374(9688):477-490.
  • [5]Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J, Fontaumard E, Brachet A, Caillot JL, Faure JL, et al.: Peritoneal carcinomatosis from non-gynecologic malignancies: Results of the EVOCAPE 1 multicentric prospective study. Cancer 2000, 88:358-363.
  • [6]Roviello F, Marrelli D, Manzoni GD, Morqaqni P, Di Leo A, Saraqoni L, De Stefano A: Prospective study of peritoneal recurrence after curative surgery for gastric cancer. Br J Surg 2003, 90:1113-1119.
  • [7]Yamada E, Miyaishi S, Nakazato H: The surgical treatment of cancer of the stomach. Int Surg 1980, 65:387-399.
  • [8]Yan TD, Black D, Suqarbaker PH, Zhu J, Yonemura Y, Petrou G, Morris DL: A systematic review and meta-analysis of the randomized controlled trials on adjuvant intra-peritoneal chemotherapy for resectable gastric cancer. Ann Surg Oncol 2007, 14:2702-2713.
  • [9]Sugarbaker PH, Yu W, Yonemura Y: Gastrectomy, peritonectomy, and perioperative intraperitoneal chemotherapy: The evolution of treatment strategies for advanced gastric cancer. Semin Surg Oncol 2003, 21:233-248.
  • [10]Xu DZ, Zhan YQ, Sun XW, Cao SM, Geng QR: Meta-analysis of intraperitoneal chemotherapy for gastric cancer. World J Gastroenterol 2004, 10(18):2727-2730.
  • [11]Shiu MH, Fortner JG: Intraperitoneal hyper-thermic treatment of implanted peritoneal can-cer in rats. Cancer Res 1980, 40:4081-4084.
  • [12]Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J: Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Cancer Res 1980, 40:256-260.
  • [13]Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996, 17:1-12.
  • [14]Cochran WG: The combination of estimates from different experiments. Biometrics 1954, 10:101-129.
  • [15]Higgins JPT, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. BMJ 2003, 327(7414):557-560.
  • [16]Koga S, Hamazoe R, Maeta M, Shimizu N, Murakami A, Wakatsuki T: Prophylactic cancer therapy for peritoneal recurrence of gastric by continuous hyperthermic peritoneal perfusion with Mitomycin C. Cancer 1988, 61(2):232-237.
  • [17]Hamatoe R, Maeta M, Kaibara N: lntraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Cancer 1994, 73(8):2048-2052.
  • [18]Fujimura T, Yonemura Y, Muraoka K, et al.: Continuous hyperthermic peritoneal perfusion for the prevention of peritoneal recurrence of gastric cancer: randomized controlled study. Wrold J Surg 1994, 18(1):150-155.
  • [19]Ikeguch M, Kondou A, Oka A, et al.: Effects of continuous hyperthermic peritoneal perfusion on prognosis of gastric cancer with serosal invasion. Eur J Surg 1995, 161(8):581-586.
  • [20]Fujimoto S, Takahashi M, Mutou T, Kobayashi K, Toyosawa T: Successful intra-peritoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer 1999, 85:529-554.
  • [21]Yonemura Y, de Aretxabala X, Fujimura T, et al.: Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomised controlled study. Hepatogastroenterol 2001, 48:1776-1782.
  • [22]Zuo Y, Xu M, Shen D, Lu JF: Postoperative intraperitionealhyperthermic chemoperfusion combined with intravenous chemotherapy for 82 advanced gastric cancer patients. Zhonghua Zhongliu Zazhi 2004, 26:247-249.
  • [23]Wei G, Fang GE, Bi JW, Shen XJ, Nie MM, Xue XC, Hua JD: Efficacy of intraoperative hypotonic peritoneal chemo-hyperthermia combined with early postoperative intraperitoneal chemotherapy on gastric cancer. Ai Zheng 2005, 24:478-482.
  • [24]Zhang GY, Chen XC, Pan K, Xia LG, Zuo M, Zheng T: Application of hyperthermic intraoperitoneal chemotherapy in patients with gastric cancer. Zhonghua Wei Chang Waike Zazhi 2007, 10(4):362-364.
  • [25]Deng HJ, Wei ZG, Zhen L, Li GX, Uang XC, Qing SH: Clinical application of perioperative continuous hyperthermic peritoneal perfusion chemotherapy for gastric cancer. Nan Fang Yi Ke Da Xue Xue Bao 2009, 29(2):295-297.
  • [26]Kim JY, Bae HS: A controlled clinical study of serosa-invasive gastric carcinoma patients who underwent surgery plus intraperitoneal hyperthermo-chemo-perfusion (IHCP). Gastric Cancer 2001, 4:27-33.
  • [27]Sugarbaker PH: Management of Gastric Cancer. Boston: Kluwer Academic Publisher; 1991:277-284.
  • [28]Weisberger AS, Levine B, Storaasli JP: Use of nitrogen mus-tard in treatment of serous effusions of neoplastic origin. JAMA 1955, 159:1704-1707.
  • [29]Crile G: Jr: Selective destruction of cancers after exposure to heat. Ann Surg 1962, 156:404-407.
  • [30]MacDonald JS, Malley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, et al.: Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001, 345:725-729.
  • [31]Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scrarffe JH, Lofts FJ, Falk SJ, Iveson TJ, et al.: Perioperative chemotherapy versus surgery alone for resectable gastro-esophageal cancer. N Engl J Med 2006, 355:11-20.
  • [32]Kazuo H, Kanji K, Atsushi I, Yamaquchi A, Nakaqawara G, Umeda S, Kusaka Y: Efficacy of Continuous Hyperthermic Peritoneal Perfusion for the Prophylaxis and Treatment of Peritoneal Metastasis of Advanced Gastric Cancer: Evaluation by Multivariate Regression Analysis. Oncology 1999, 57:106-114.
  • [33]Sugarbaker PH: Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol 1998, 14(3):254-261.
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