Abstract:Objective To analyze the long-term clinical efficacy of tumor cytoreductive surgery (CRS) combined hyperthermic intraperitoneal chemotherapy (HIPEC) versus alone systemic chemotherapy (SC) for peritoneal carcinomatosis from gastric cancer (PCGC) to find a better treatment regimen for patients who were suitable for it.Methods A retrospective study was conducted on 96 patients diagnosed with PCGC in Zhongnan Hospital of Wuhan University between January 2014 and December 2017.The patients were divided into CRS+HIPEC+SC group( n =56) and SC alone group ( n=40) according to the treatment regimens and were followed up every 3 months within two years and every 6 months after two years.The latest follow-up was on May 31,2019.The overall survival time (OS) was observed and compared between two groups.Results Kaplan-Meier analysis showed that the median OS in CRS+HIPEC+SC group was significant higher than that in SC alone group ［19.7 (95% CI :15.8-23.6) months vs 8.0 (95% CI :5.9-10.1)months, P＜0.01］.Multivariate Cox regression analysis indicated that peritoneal carcinomatosis index (PCI)>20,incomplete CRS and of systemic chemotherapy <6 cycles were the independent risk factors affecting the prognosis of patients treated with CRS combined with HIPEC( P ＜0.05, P ＜0.01).There was no significant difference in the median OS between the patients without complete CRS or PCI>20 in CRS+HIPEC+SC group and the patients in SC alone group ( P>0.05).The median OS of patients with less than 6 cycles of SC in CRS+HIPEC+SC group was 10.0 months,which was significantly higher than that in SC alone group( P<0.01).Conclusions Compared with SC alone,CRS+HIPEC could significantly prolong the survival of PCGC patients and the benefit group is patients with PCI≤20 points and CRS completed ; while combined with≥6 cycles of SC can increase the survival benefit.