Efficacy of additional hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: an updated systematic review and meta-analysis

Patients receiving additional HIPEC had significantly better OS than those in the control group (HR = 0.71, 95%CI: 0.56–0.91; <i>p</i> = 0.008). In subgroup analyses, patients receiving additional HIPEC showed better OS than those in the control group in studies combined with cytoreductive surgery (CRS) (HR = 0.64, 95%CI: 0.50–0.80; <i>p</i> < 0.001), Western studies (HR = 0.67, 95%CI: 0.53–0.85; <i>p</i> < 0.001), and cohort studies (HR = 0.63, 95%CI: 0.55–0.72; <i>p</i> < 0.001).

In contrast, studies using additional HIPEC showed no significant OS benefit in RCTs, Eastern studies, studies without CRS, or the subgroups defined by HIPEC drug regimen.</p> <p>In the overall analysis, additional HIPEC was associated with longer OS in patients with gastric cancer and PM, particularly in studies in which HIPEC was combined with CRS. However, the apparent survival benefit was mainly observed in observational cohort studies and was not confirmed in the pooled analysis of RCTs.</p>