Background: Peritoneal carcinomatosis is one of deadliest metastatic patterns of gastric cancer, being associated with a median overall survival (OS) of 4 months. Up to now, palliative systemic chemotherapy (pSC) has been the only recommended treatment. The aim of this study is to evaluate a potential survival benefit after CRS + HIPEC compared to pSC. Methods: A systematic review was conducted according to the PRISMA guidelines in March 2024. Manuscripts reporting patients with peritoneal carcinomatosis from gastric cancer treated with CRS + HIPEC were included. A meta-analysis was performed, comparing the survival results between the CRS + HIPEC and pSC groups, and the primary outcome was the comparison in terms of OS. We performed random-effects meta-analysis of odds ratios (ORs). We assessed heterogeneity using the Q2 statistic. Results: Out of the 24 papers included, 1369 patients underwent CRS + HIPEC, with a median OS range of 9.8–28.2 months; and 103 patients underwent pSC, with a median OS range of 4.9–8 months. CRS + HIPEC was associated with significantly increased survival compared to palliative systemic chemotherapy (−1.8954 (95% CI: −2.5761 to −1.2146;p< 0.001). Conclusions: CRS + HIPEC could provide survival advantages in gastric cancer peritoneal metastasis compared to pSC.
背景：腹膜癌是胃癌最致命的转移模式之一，中位总生存期仅为4个月。迄今为止，姑息性全身化疗是唯一推荐的治疗方法。本研究旨在评估与姑息性全身化疗相比，肿瘤细胞减灭术联合腹腔热灌注化疗可能带来的生存获益。方法：于2024年3月遵循PRISMA指南进行系统综述，纳入报道接受肿瘤细胞减灭术联合腹腔热灌注化疗治疗的胃癌腹膜转移患者的研究文献。通过荟萃分析比较肿瘤细胞减灭术联合腹腔热灌注化疗组与姑息性全身化疗组的生存结果，主要结局指标为总生存期的比较。采用随机效应模型对比值比进行荟萃分析，并使用Q²统计量评估异质性。结果：在纳入的24篇文献中，1369例患者接受肿瘤细胞减灭术联合腹腔热灌注化疗，中位总生存期为9.8-28.2个月；103例患者接受姑息性全身化疗，中位总生存期为4.9-8个月。与姑息性全身化疗相比，肿瘤细胞减灭术联合腹腔热灌注化疗显著提高生存率（-1.8954，95%置信区间：-2.5761至-1.2146；p<0.001）。结论：对于胃癌腹膜转移，肿瘤细胞减灭术联合腹腔热灌注化疗相较于姑息性全身化疗可能提供生存优势。
肿瘤(癌症)患者之家