Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience

Abstract Background The rationale behind the use of HIPEC involves targeted elimination of microscopic peritoneal metastasis, a common route for GCa dissemination, thereby improving the overall survival and reducing recurrences. Moreover, the reasoning behind the use of IORT is enhanced loco-regiona...

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Main Authors: Marwan M. Alaswad, Tarek Z. Arabi, Asma S. Alshahrani, Belal N. Sabbah, Heba W. Jaamour, Abdullah A. AlOtry, Tariq W. Saleh, Ziad H. Alhosainy, Fadwa H. Elkordy, Aya I. Elnegali, Mohamed H. Tlayjeh, Firas E. Kseibi, Ayman Z. Azzam, Tarek M. Amin
Format: Article
Language:English
Published: BMC 2025-02-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-025-03678-5
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author Marwan M. Alaswad
Tarek Z. Arabi
Asma S. Alshahrani
Belal N. Sabbah
Heba W. Jaamour
Abdullah A. AlOtry
Tariq W. Saleh
Ziad H. Alhosainy
Fadwa H. Elkordy
Aya I. Elnegali
Mohamed H. Tlayjeh
Firas E. Kseibi
Ayman Z. Azzam
Tarek M. Amin
author_facet Marwan M. Alaswad
Tarek Z. Arabi
Asma S. Alshahrani
Belal N. Sabbah
Heba W. Jaamour
Abdullah A. AlOtry
Tariq W. Saleh
Ziad H. Alhosainy
Fadwa H. Elkordy
Aya I. Elnegali
Mohamed H. Tlayjeh
Firas E. Kseibi
Ayman Z. Azzam
Tarek M. Amin
author_sort Marwan M. Alaswad
collection DOAJ
description Abstract Background The rationale behind the use of HIPEC involves targeted elimination of microscopic peritoneal metastasis, a common route for GCa dissemination, thereby improving the overall survival and reducing recurrences. Moreover, the reasoning behind the use of IORT is enhanced loco-regional control and, therefore, reducing recurrence rates. Methods From February 2013 to June 2023, all GCa patients who underwent HIPEC plus IORT during surgery were included in this study. Median overall survival (OS) and disease-free (DFS) survival were used to evaluate the efficacy of this treatment strategy amongst GCa patients, along with the rate of occurrence and severity of post-operative complications associated with this treatment strategy. Results The median OS and DFS were 63 and 87 months, respectively. More than one-third of the patients in our cohort did not develop any post-operative complications. In patients who developed post-operative complications, the median number of post-operative complications was 1 (IQR 1–2). Most encountered complications were Clavien-Dindo (CD) grade II complications (33.33%) and no in-hospital mortality was observed. Conclusions This complex, multimodal treatment strategy results in a significantly prolonged OS and DFS when compared to other treatment strategies for gastric cancer patients, with no added morbidity or mortality.
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spelling doaj-art-ce454fce06704ad28186f836bc9ea98a2025-08-20T02:15:16ZengBMCWorld Journal of Surgical Oncology1477-78192025-02-0123111410.1186/s12957-025-03678-5Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experienceMarwan M. Alaswad0Tarek Z. Arabi1Asma S. Alshahrani2Belal N. Sabbah3Heba W. Jaamour4Abdullah A. AlOtry5Tariq W. Saleh6Ziad H. Alhosainy7Fadwa H. Elkordy8Aya I. Elnegali9Mohamed H. Tlayjeh10Firas E. Kseibi11Ayman Z. Azzam12Tarek M. Amin13College of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityDepartment of Population Health, King Abdullah International Medical Research CenterCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityCollege of Medicine, Alfaisal UniversityDepartment of Surgical Oncology, King Faisal Specialist Hospital and Research CenterDepartment of Surgical Oncology, King Faisal Specialist Hospital and Research CenterAbstract Background The rationale behind the use of HIPEC involves targeted elimination of microscopic peritoneal metastasis, a common route for GCa dissemination, thereby improving the overall survival and reducing recurrences. Moreover, the reasoning behind the use of IORT is enhanced loco-regional control and, therefore, reducing recurrence rates. Methods From February 2013 to June 2023, all GCa patients who underwent HIPEC plus IORT during surgery were included in this study. Median overall survival (OS) and disease-free (DFS) survival were used to evaluate the efficacy of this treatment strategy amongst GCa patients, along with the rate of occurrence and severity of post-operative complications associated with this treatment strategy. Results The median OS and DFS were 63 and 87 months, respectively. More than one-third of the patients in our cohort did not develop any post-operative complications. In patients who developed post-operative complications, the median number of post-operative complications was 1 (IQR 1–2). Most encountered complications were Clavien-Dindo (CD) grade II complications (33.33%) and no in-hospital mortality was observed. Conclusions This complex, multimodal treatment strategy results in a significantly prolonged OS and DFS when compared to other treatment strategies for gastric cancer patients, with no added morbidity or mortality.https://doi.org/10.1186/s12957-025-03678-5Gastric cancerHyperthermic intraperitoneal chemotherapyIntraoperative radiation therapyPeritoneal carcinomatosisOverall survivalDisease free survival
spellingShingle Marwan M. Alaswad
Tarek Z. Arabi
Asma S. Alshahrani
Belal N. Sabbah
Heba W. Jaamour
Abdullah A. AlOtry
Tariq W. Saleh
Ziad H. Alhosainy
Fadwa H. Elkordy
Aya I. Elnegali
Mohamed H. Tlayjeh
Firas E. Kseibi
Ayman Z. Azzam
Tarek M. Amin
Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
World Journal of Surgical Oncology
Gastric cancer
Hyperthermic intraperitoneal chemotherapy
Intraoperative radiation therapy
Peritoneal carcinomatosis
Overall survival
Disease free survival
title Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
title_full Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
title_fullStr Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
title_full_unstemmed Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
title_short Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer: a 10-year single center experience
title_sort cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and intraoperative radiation therapy in the management of gastric cancer a 10 year single center experience
topic Gastric cancer
Hyperthermic intraperitoneal chemotherapy
Intraoperative radiation therapy
Peritoneal carcinomatosis
Overall survival
Disease free survival
url https://doi.org/10.1186/s12957-025-03678-5
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