Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 3:11:795390.
doi: 10.3389/fonc.2021.795390. eCollection 2021.

Effect of HIPEC on Peritoneal Recurrence in Peritoneal Metastasis Treated With Cytoreductive Surgery: A Systematic Review

Daniel Ren Yi Yap  1   2   3 , Jolene Si Min Wong  1   2   4   5 , Qiu Xuan Tan  1   2   3 , Joey Wee-Shan Tan  1   2   3 , Claramae Shulyn Chia  1   2   4   5 , Chin-Ann Johnny Ong  1   2   3   4   5   6
Affiliations

Effect of HIPEC on Peritoneal Recurrence in Peritoneal Metastasis Treated With Cytoreductive Surgery: A Systematic Review

Daniel Ren Yi Yap et al. Front Oncol. .

Abstract

Background: Peritoneal metastasis (PM) is a late-stage manifestation of intra-abdominal malignancies. The current standard of care indicates that cure can only be achieved with cytoreductive surgery (CRS) which is often indicated with concurrent adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC). However, the utility of HIPEC within subsets of PM is not fully understood. We seek to compare the effectiveness of HIPEC in improving peritoneal recurrence rates in PM of different origins.

Methods: We conducted a systematic review of trials on the PubMed, EMBASE, and Cochrane databases, last searched in August 2021. Biases were assessed using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials as well as the Methodological Index for Non-Randomized Studies (MINORS) framework.

Results: 7 gastric PM studies, 3 ovarian PM studies, and 3 colorectal PM studies were included. Recurrence-free survival was improved in the HIPEC + CRS cohort in 5 gastric trials but only 1 ovarian trial and none of colorectal origin.

Discussion: Our findings indicate decent effectiveness of HIPEC in gastric PM, but limited utility in ovarian and colorectal PM. Limitations in the current literature are attributed to the paucity of data available, a lack of homogeneity and consideration of novel and personalised treatment regimens. We implore for further studies to be conducted with a focus on patient selection and stratification, and suggest a reframing of approach towards modern molecular and targeted therapeutic options in future studies of HIPEC.

Systematic review registration: https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/60c1ffff0c1b78001e8efbe3/, identifier reviewregistry1166.

Keywords: colorectal; cytoreductive surgery; gastric; hyperthermic intraperitoneal chemotherapy (HIPEC); ovarian; peritoneal metastasis; recurrence.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart denoting our literature search strategy.
See this image and copyright information in PMC

References

    1. Coccolini F, Gheza F, Lotti M, Virzì S, Iusco D, Ghermandi C, et al. . Peritoneal Carcinomatosis. World J Gastroenterol (2013) 19:6979–94. doi: 10.3748/wjg.v19.i41.6979 - DOI - PMC - PubMed
    1. McMullen JRW, Selleck M, Wall NR, Senthil M. Peritoneal Carcinomatosis: Limits of Diagnosis and the Case for Liquid Biopsy. Oncotarget (2017) 8:43481–90. doi: 10.18632/oncotarget.16480 - DOI - PMC - PubMed
    1. Chia CS, You B, Decullier E, Vaudoyer D, Lorimier G, Abboud K, et al. . Patients With Peritoneal Carcinomatosis From Gastric Cancer Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is Cure a Possibility? Ann Surg Oncol (2016) 23:1971–9. doi: 10.1245/s10434-015-5081-3 - DOI - PubMed
    1. Goodman MD, McPartland S, Detelich D, Saif MW. Chemotherapy for Intraperitoneal Use: A Review of Hyperthermic Intraperitoneal Chemotherapy and Early Post-Operative Intraperitoneal Chemotherapy. J Gastrointest Oncol (2016) 7:45–57. doi: 10.3978/j.issn.2078-6891.2015.111 - DOI - PMC - PubMed
    1. González-Moreno S, González-Bayón LA, Ortega-Pérez G. Hyperthermic Intraperitoneal Chemotherapy: Rationale and Technique. World J Gastrointest Oncol (2010) 2:68–75. doi: 10.4251/wjgo.v2.i2.68 - DOI - PMC - PubMed

Publication types

LinkOut - more resources