Abstract 464P
Background
Total or subtotal gastrectomy is the gold standard for managing localized gastric cancer. However, recurrence rates remain high despite perioperative chemotherapy and R0 resection. This study evaluates the impact of prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) and intraoperative radiotherapy (IORT) on recurrence and survival in patients undergoing gastrectomy.
Methods
A retrospective study included patients with localized gastric adenocarcinoma undergoing curative surgical resection. Data collected included patients' characteristics, surgical procedure type, hospital stay duration, recurrence, and survival outcomes.
Results
100 patients (median age: 56 years, IQR: 21-87) were enrolled, including 70 males and 61 with ECOG performance status 0-1. Tumor sites were distributed as follows: gastro-esophageal junction (27), fundal (18), distal (40), and linitis plastica (2). All patients received neoadjuvant chemotherapy (EOX, FOLFOX, or FLOT regimens). After curative surgical resection, 48 patients underwent HIPEC and IORT. Pathological stages included T0 (6), T1 (8), T2 (21), T3 (48), T4 (15), and Tx (2); N0 (47), N1 (18), N2 (17), and N3 (18). Median follow-up duration was 70.6 months (95% CI 48.5-92.8). The standard surgery group had not reached median relapse-free survival (RFS), while the HIPEC/IORT group had a median RFS of 35.4 months (95% CI 11.6-59.2; p=0.490). Median overall survival (OS) was not reached for the standard surgery group and 48 months (95% CI NR-NR) for the HIPEC/IORT group (p=0.338). Multivariate analysis, considering prognostic factors including HIPEC/IORT, showed significant benefits in RFS and OS for adjuvant chemotherapy and pathological N0 status. Hospital and intensive care unit stays were longer in the HIPEC/IORT group (44 days and 5 days, respectively) compared to the standard surgery group (20 days and 2 days).
Conclusions
Incorporating prophylactic HIPEC and IORT into standard gastrectomy for localized gastric cancer did not significantly improve RFS or OS. However, adjuvant chemotherapy and pathological N0 status showed significant benefits.
Legal entity responsible for the study
Shouki Bazarbashi, MBBS.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.