Table 2.
Published studies of therapeutic HIPEC in gastric cancer
| Author | Type of study | No. of patients | Control arm | Drug used for HIPEC, Dose | Complete cytoreduction | Morbidity | Mortality | Survival |
|---|---|---|---|---|---|---|---|---|
| Fujimoto et al. [54] | Prospective | 27 | only surgery | MMC 10 μg/ml | NA | NA | NA | 6 month survival- 94 vs 57 %, p = 0.001 Death due to Peritoneal recurrence- 10 vs 100 % |
| Yonemura et al. [55] | Prospective | 41 | Nil | MMC 5 μg/ml CDDP 30 μg/ml |
NA | 12 % | 0 % | Median survival-14.5 months 3-year 28.5 % |
| Yonemura et al. [15] | Prospective | 83 | Nil | MMC 30 mg CDDP 300 mg Etoposide 150 mg |
33.7 % | NA | NA | 5-year survival - overall-11 % (CCR0/1–17 %, CCR2- 2 %) |
| Fujimoto et al. [56] | Prospective case-control | 66 | only surgery | MMC 10 μg/ml | NA | NA | NA | 3-year & 5-year survival (HIPEC vs control- 42 vs 0 % & 31 vs 0 %; p = 0.001) Death due to peritoneal recurrence-HIPEC vs control 27 vs 94 % (p = 7.077 × 100-7). |
| Hirose et al. [41] | Prospective case- control | 37 | CRS alone | MMC 20 mg CDDP 100 mg Etoposide 100 mg |
HIPEC vs control- 29.4 vs 15 % | HIPEC vs control-35.2 vs 20 % | HIPEC vs control-5.8 vs 0 % | Median survival: HIPEC vs control-11 vs 6 months 1-year survival: HIPEC vs control-44.4 vs 15.8 %, p = 0.04) |
| Glehen et al. [57] | Prospective | 49 | Nil | MMC 40-60 mg | 10.2 % | Overall-27 % | 4 % | Median overall survival -10.3 months (CCR0/1 vs CCR2- 21.3 vs 6.6 months, p < 0.001; Gilly Stage I/II PC vs stage III/IV PC- 19 vs 6.6 months, p = 0.004) ) 5-year overall survival -16 % (CCR0/1–29.4 %) |
| Yonemura et al. [56] | Retrospective | 107* | conventional surgery + HIPEC | MMC 30 mg CDDP 300 mg Etoposide 150 mg |
Overall 43.9 % Study arm- 69 % Control- 28 % |
Overall - 21.5 % Study arm- 43 % control- 8 % |
Overall 2.8 % Study arm- 7 % Control- 0 % |
5-year survival: overall-6.7 %; study arm-27 %; CCR0-13 %, CCR ≥ 1–2 % (overall) Median survival: CCR0/ CCR ≥ 1: 15.5 months/ 7.9 months (all patients); CCR0/CCR≥: 19.2 months/ 7.8 months (study arm) |
| Glehen et al. [57] | Retrospective | 159 | Nil | HIPEC: MMC 30–50 mg/m2 ± CDDP 50–100 mg/m2
Oxaliplatin 360–460 mg/m2 ± irinotecan 100– 200 mg/m2 ± I.V. 5-FU EPIC: MMC 10 mg/m2 5-FU 600 mg/m2 |
56 % | 27.8 % | 6.5 % | 5-year survival: overall-13 %; CCR0-23 % Median survival:9.2 months |
| Yang et al. [60] | Randomised controlled trial | 68 | only CRS | MMC 30 mg CDDP 120 mg |
58.8 % each arm | HIPEC vs control- 14.7 vs 11.7 % | Nil | Median survival (months): HIPEC vs control- 11 vs 6.5, p = 0.04 (all pts) 2-year, 3-year survival (HIPEC vs control): 14.7 vs 5.9 %, 5.9 vs 0 % |
MMC-mitomycin-c, CDDP- cisplatin, 5-FU- 5-fluorouracil, *study arm- peritonectomy with HIPEC