• Xiaojiang Wu, Ziyu Li, Ziran Li, Yongning Jia, Fei Shan, Xin Ji, Zhaode Bu, Lianhai Zhang, Aiwen Wu, and Jiafu Ji.
• Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, China.
• J Surg Oncol. 2015 Jun 1; 111 (7): 840-7.

BackgroundOur aim is to evaluate the safety and efficacy of two treatment strategies, hyperthermic intraperitoneal chemotherapy (HIPEC) plus simultaneous versus staged cytoreductive surgery (CRS) in patients with occult peritoneal metastasis of gastric cancer (GC).MethodsWe retrospectively reviewed 26 GC patients who were potential curatively resectable by pre-operative evaluation and found occult peritoneal metastasis by diagnostic laparoscopy. Patients were treated by HIPEC plus either simultaneous CRS (CRS+HIPEC group, n = 11) or staged CRS after systematic chemotherapy (HIPEC+Chemo+CRS group, n = 15).ResultsThere is no mortality observed in both groups. The treatment complications in two group is comparable (P = 0.683), with 26.7% (4/15) in HIPEC+Chemo+CRS group, and 36.4% (4/11) in CRS+HIPEC group, respectively. The compliance of patients undergoing subsequent chemotherapy is higher in HIPEC+Chemo+CRS group (93.3%, 14/15) than that of CRS+HIPEC group (45.5%, 5/11) (P = 0.021). The mean interval time between CRS and first post-CRS systematic chemotherapy were 42.0 ± 12.0 days in HIPEC+Chemo+CRS group versus 69.8 ± 36.3 in CRS+HIPEC group (P = 0.163), respectively. The median OS in the HIPEC+Chemo+CRS group was 25.0 months, while 28.2 months in the CRS+HIPEC group (P = 0.738).ConclusionFor resectable GC patients with laparoscopic findings of occult peritoneal metastasis, HIPEC plus staged CRS is with better tolerance and compliance than simultaneous CRS.© 2015 Wiley Periodicals, Inc.

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