TY - JOUR
T1 - Hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric cancer with peritoneal metastasis - Joint analysis of European GASTRODATA and American national cancer database
AU - Pelc, Zuzanna
AU - Sędłak, Katarzyna
AU - Endo, Yutaka
AU - Van Sandick, Johanna
AU - Gisbertz, Suzanne
AU - Pera, Manuel
AU - Baiocchi, Gian Luca
AU - Morgagni, Paolo
AU - Framarini, Massimo
AU - Hoelscher, Arnulf
AU - Moenig, Stefan
AU - Kołodziejczyk, Piotr
AU - Gockel, Ines
AU - Piessen, Guillaume
AU - Eveno, Clarisse
AU - Da Costa, Paulo Matos
AU - Davies, Andrew
AU - Baker, Cara
AU - Allum, William
AU - Romario, Uberto Fumagalli
AU - Rosati, Riccardo
AU - Reim, Daniel
AU - D'ugo, Domenico
AU - Wijnhoven, Bas
AU - De Manzoni, Giovanni
AU - Kielan, Wojciech
AU - Schneider, Paul
AU - Badgwell, Brian B.
AU - Pawlik, Timothy M.
AU - Polkowski, Wojciech
AU - Rawicz-Pruszyński, Karol
N1 - Publisher Copyright:
© 2025 Elsevier Inc.
PY - 2025/4
Y1 - 2025/4
N2 - Introduction: Palliative chemotherapy is the current standard among advanced gastric cancer (GC) patients with peritoneal metastasis (PM), while the role of gastrectomy with cytoreductive surgery and HIPEC remains unclear. The current study aimed to assess treatment outcomes among GC patients with PM undergoing gastrectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) using multinational cancer registries. Methods: The analysis (2012–2022) included stage IV GC patients with PM undergoing gastrectomy and HIPEC from the European GASTRODATA Registry (EU cohort) and the American National Cancer Database (NCDB, U.S. cohort). The study outcomes were textbook oncological outcome (TOO) assessment and overall survival (OS). Results: Among 193 patients, 49.7 % were from the EU cohort and 50.3 % from the U.S. cohort. EU cohort had significantly higher rates of pT4 tumors (EU: 50 % vs U.S.: 40.2 %), metastatic lymph nodes (EU: 68.8 % vs U.S.: 54.6 %), and ≥16 lymph nodes evaluated (EU: 91.7 % vs U.S.: 68 %). Postoperatively, the EU cohort had longer hospital stay (EU: 53.1 % vs 22.2 %, p < 0.001), with no significant differences in 30-day readmission (EU: 14.6 % vs U.S: 7.2 %, p = 0.11) and 90-day mortality (EU: 4.2 % vs U.S.: 9.3 %, p = 0.25). TOO rates were 30.2 % and 32 % for EU and U.S. cohorts, respectively. Within the U.S. cohort, TOO achievement was associated with improved 1- (86.7 % vs. 57.4 %), 3- (55.8 % vs. 29.7 %), and 5-year OS (50.2 % vs. 29.7 %) (p = 0.0025) survival compared with non-TOO. Conclusions: Among patients with GC and PM undergoing gastrectomy and HIPEC, achievement of TOO was associated with decreased risk of postoperative complications (EU cohort) and improved long-term survival (U.S. cohort).
AB - Introduction: Palliative chemotherapy is the current standard among advanced gastric cancer (GC) patients with peritoneal metastasis (PM), while the role of gastrectomy with cytoreductive surgery and HIPEC remains unclear. The current study aimed to assess treatment outcomes among GC patients with PM undergoing gastrectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) using multinational cancer registries. Methods: The analysis (2012–2022) included stage IV GC patients with PM undergoing gastrectomy and HIPEC from the European GASTRODATA Registry (EU cohort) and the American National Cancer Database (NCDB, U.S. cohort). The study outcomes were textbook oncological outcome (TOO) assessment and overall survival (OS). Results: Among 193 patients, 49.7 % were from the EU cohort and 50.3 % from the U.S. cohort. EU cohort had significantly higher rates of pT4 tumors (EU: 50 % vs U.S.: 40.2 %), metastatic lymph nodes (EU: 68.8 % vs U.S.: 54.6 %), and ≥16 lymph nodes evaluated (EU: 91.7 % vs U.S.: 68 %). Postoperatively, the EU cohort had longer hospital stay (EU: 53.1 % vs 22.2 %, p < 0.001), with no significant differences in 30-day readmission (EU: 14.6 % vs U.S: 7.2 %, p = 0.11) and 90-day mortality (EU: 4.2 % vs U.S.: 9.3 %, p = 0.25). TOO rates were 30.2 % and 32 % for EU and U.S. cohorts, respectively. Within the U.S. cohort, TOO achievement was associated with improved 1- (86.7 % vs. 57.4 %), 3- (55.8 % vs. 29.7 %), and 5-year OS (50.2 % vs. 29.7 %) (p = 0.0025) survival compared with non-TOO. Conclusions: Among patients with GC and PM undergoing gastrectomy and HIPEC, achievement of TOO was associated with decreased risk of postoperative complications (EU cohort) and improved long-term survival (U.S. cohort).
UR - https://www.scopus.com/pages/publications/85217914042
U2 - 10.1016/j.amjsurg.2025.116235
DO - 10.1016/j.amjsurg.2025.116235
M3 - Article
C2 - 39954554
AN - SCOPUS:85217914042
SN - 0002-9610
VL - 242
JO - American Journal of Surgery
JF - American Journal of Surgery
M1 - 116235
ER -
