Analysis Of Prognostic Factors Of Advanced Gastric Cancer Which Have Had Operation And Effectiveness And Safety Of Hyperthermic Intrapertioneal Chemotherapy

ObjectiveThis study was to discovery the factors associated with the prognosis of patients with advanced gastric cancer and evaluate the efficacy and safety of hyperthermic Intraperitoneal chemotherapy(HIPEC).MethodsA total of 96 patients that had been diagnosed with advanced gastric cancer and that had undergone laparoscopic gastrectomy between October 2010 and December 2017 in Zhengzhou University People's Hospital with complete follow-up data were enrolled in this study.One-way analysis of variance(ANOVA)compared the correlation between the prognosis of gastric cancer patients and sex,age,pathological typing,tumor diameter,with or without HIPEC,N for lymph node,systemic chemotherapy,vascular invasion and pTNM stages,and Multivariate analysis of COX regression models was performded for discovering the factors associated with the prognosis of patients.50 patients underwent hyperthermic Intraperitoneal Chemotherapy combined with systemic intravenous chemotherapy(HIPEC group).46 patients underwent systemic intravenous chemotherapy only with SOX(oxaliplatin+Gio)(control group),The survival rate,disease-free survival time,overall survival time and safety were analysised between two groups.ResultsThe differences of sex,age,pathological typing had no statistical significance(P>0.05),while comparisons of tumor diameter,group,N for lymph node,systemic chemotherapy,vascular invasion and pTNM stages showed statistical significance(P<0.05),One-way analysis of variance(ANOVA)indicated the correlation between the prognosis of gastric cancer patients and tumor diameter,with or without HIPEC,N for lymph node,systemic chemotherapy,vascular invasion and pTNM stages of patients(P<0.05),Multivariate analysis of COX regression models was performded for discovering the factors associated with the prognosis of patients,and the results suggested that HIPEC(P=0.036),systemic chemotherapy?6 cycles were the independent predictors for better survival.,while pTNM stages(P<0.001),vascular invasion was the independent risk factor affecting the prognosis of advanced gastric cancer patients;there was no significant differences in the 1-year survival rate(96%)in HIPEC group compared with that(93.5%)in control group(P=0.579).the 3-and 5-years survival rates were significantly higher in HIPEC group(78%,54%)than those in control group(54.3%,32.6%)(P<0.05),the median DFS of the HIPEC group and the control group were 38.0 months(95% CI: 35.35-40.65 months)and 26.5 months(95% CI: 22.59-30.41 months),(P=0.045),the median OS of the HIPEC group and the control group were 61.0 months(95% CI: 47.14-58.55 months)and 43.0 months(95% CI: 39.28-50.40 months),(P=0.014),the difference was statistically significant(P = 0.014).there were 14(14.6%)cases of severe adverse reactions(SAE)during the treatment,including 7(14.0%)cases happened in the HIPEC group and 7(15.2%)cases in the control group,the difference was not statistically significant(P = 0.760).ConclusionsHIPEC,systemic chemotherapy,pTNM stages,vascular invasion were the independent factor affecting the prognosis of advanced gastric cancer patients;The laparoscopic gastrectomy combined with HIPEC method can increase 3-year and 5-year survival rate and prolong the median progression-free survival and the median overall survival time of advanced gastric cancer,and no serious adverse events are significantly increased.