The role of prophylactic
hyperthermic intraperitoneal chemotherapy (p-
HIPEC) in serosa invasive
gastric cancers without gross or microscopic
peritoneal disease, to reduce the rate of peritoneal relapse is an area of ongoing research. Although p-
HIPEC is effective in reducing the rate of peritoneal relapse and improving disease free and overall survival with or without
adjuvant chemotherapy, when added to curative surgery in locally advanced, non-metastatic
gastric cancers, the available literature is at best, heterogeneous, centre-specific and skewed. Apart from that, variations in the systemic
therapy used, and the presence of the associated nodal disease further complicate this picture. To evaluate the role of p-
HIPEC the PubMed, Cochrane central register of clinical trials, and the American Society of Clinical Oncology (ASCO) meeting library were searched with the search terms, "
gastric", "cancer", "
hyperthermic", "intraperitoneal", "chemotherapy", prophylactic", "
HIPEC" in various combinations, and a critical review of the available evidence was done. Although p-
HIPEC is a promising
therapy in the management of locally advanced
gastric cancers, the current evidence is insufficient to recommend its inclusion into routine clinical practice. Future research should be directed towards identification of the appropriate patient subset and towards redefining its role with current peri-operative systemic
therapies.