Adjuvant Hyperthermic Intraperitoneal Chemotherapy for Locally Advanced Gastric Cancer

Treatment Plan:

Patients undergoing definitive resection for gastric cancer and meeting the eligibility criteria will be treated with HIPEC using a single dose of Mitomycin 15mg/m2 and Cisplatin 50mg/m2 at 41-42 C for 90 minutes. HIPEC will be performed after resection but before anastomosis. Both Cisplatin and Mitomycin are commercially available chemotherapeutic agents and will be obtained as marketed drugs.

Outcome Measures:

Patients will be followed for 90 days following surgery. All postoperative complications will be recorded and graded according to the modified Clavien-Dindo classification.

Schedule for Follow Up:

Trial-related patient assessments will be performed daily while the patient remains in the hospital for postoperative care, and then during postoperative clinic visits. The final postoperative clinic visit for evaluation of study outcomes and complications should occur between postoperative days 90 and 95 to allow for a cumulative assessment of the patient's perioperative complications, if any.

Inclusion criteria

• Patients aged 18-75 with biopsy-proven gastric adenocarcinoma
• Tumor clinically staged T3 or T4 and/or nodes staged clinically positive
• ECOG performance status < 2

Exclusion criteria

• Distant metastases
• Peritoneal carcinomatosis
• Synchronous malignancy
• Tumors at the gastroesophageal junction
• Recurrent gastric adenocarcinoma
• Creatinine >/= 1.5
• Bilirubin >/= 2
• INR >/= 2
• Allergy to drugs included in the treatment plan
• Pregnancy
• Contraindication to major surgery