Kunal Nandy, Consultant Hepatobiliary, Pancreatic and Gastrointestinal (HPB and GI) Surgical Oncologist at Bagchi Sri Shankara Cancer Centre and Research Institute, shared recent article he and his colleagues authored:
“The study analyzed 558 patients with gastric adenocarcinoma who received neoadjuvant chemotherapy followed by radical gastrectomy (2017–2023), reflecting current multimodal treatment practices.
It focuses on patients who are cytology-positive (free cancer cells in peritoneal cytology), but without overt peritoneal metastasis – a challenging group where the benefit of additional intraperitoneal therapy (Hyperthermic Intraperitoneal Chemotherapy / HIPEC) has remained uncertain.
Their findings suggest that nodal metastasis — rather than peritoneal cytology alone — appears to dominate prognosis, and that the role of prophylactic HIPEC in this setting remains unproven.
Why this matters: For patients without visible peritoneal disease but with positive peritoneal cytology, the decision to offer HIPEC continues to be controversial. This data urges caution and reinforces the need for well-designed prospective trials to define which subgroups might actually benefit. As someone involved in surgical oncology research, this adds a new layer of evidence to ongoing debates about aggressive peritoneal interventions. It also underscores the critical importance of patient selection, realistic risk–benefit discussions, and multimodal care planning.”
Title: The Role of HIPEC in Isolated Cytology-Positive Gastric Cancer: Nodal Metastasis Dominates Prognosis, HIPEC Remains Unproven
Authors: Kunal Nandy, Amir Parray, Akshay Dhaiya, Amit Chopde, Vishnu Menon, Vikas Ostwal, Anant Ramaswamy, Prabhat Bhargav, Manish S. Bhandare, Shailesh V. Shrikhande, Vikram A. Chaudhari
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