M.Yu. Revtovich
Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
Revtovich Mikhail Yu. ― Doct. of Sci. (Med.), Associate Professor of the Department of Oncology of Belarusian Medical Academy of Postgraduate Education
3, build. 3 P. Brovki Str., Minsk, 220013, Republic of Belarus, tel.: +375 (17) 389-95-98, +375 (447) 71-23-30, e-mail: mihail_revtovich@yahoo.com, SPIN-код: 1738-0528, ORCID ID: 0000-0001-7202-6902
Abstract
The goal of the study is to assess the efficacy of local intraperitoneal chemotherapy (HIPEC) to prevent metachronous peritoneal dissemination in stage IIА–IIIC stomach cancer patients who underwent radical surgery.
Material and methods. This prospective randomized study assessed immediate and long-term outcomes of treating a cohort of 157 patients with resectable stage IIА-IIIC stomach cancer (types III-IV according to Borrmann, рТ2N1-3M0 and рТ3-4N0) including 67 patients who underwent HIPEC administered by means of cisplatin loaded on 6-carboxylcellulose polymer at a dose of 50 mg/m2.
Results. HIPEC-treated radically operated patients had no serious toxic complications (according to CTCAE, version 5.0). It is also noteworthy to mention: (1) an acceptable level of endogenous intoxication that was comparable to that in standard surgical treatment, it was of reversible nature and had no effect on the course of post-surgery patient management; (2) a decrease in 4-year cumulative incidence of peritoneal dissemination from 44,6±7,20% to 10,9±4,70% (рGray<0,001); and (3) an increase in 4-year survival (a) adjusted from 43,9±7,6% to 67,0±7,5% (рlog-rank=0,04), and (b) dissemination-free survival from 43,6±7,4% to 67,7%±7,4% (рlog-rank=0,03).
Conclusion. The study results highlight the efficacy of administering local adjuvant intraperitoneal chemotherapy to stage IIА–IIIC stomach cancer patients as a complement to systemic chemotherapy to prevent metachronous peritoneal dissemination.
Key words: gastric cancer, peritoneal dissemination, intraperitoneal chemotherapy.