Efficacy and Outcomes of Intraoperative Extensive Lavage Plus Surgery Versus Surgery Alone in Patients with Advanced Gastric Cancer: A Multicenter Randomized Controlled Trial

Abstract Objective: This randomized study aims to evaluate the efficacy and long-term outcome of advanced gastric cancer patients with extensive intraoperative peritoneal lavage (EIPL). Methods: A total of 150 patients with advanced gastric cancer were enrolled in this study, the patients were randomly allocated to 2 groups: the group of surgery alone (non-EIPL group), the group of surgery plus EIPL (EIPL group). The surviving rate analysis was compared by the Kaplan–Meier method. The prognostic factors were carried out using the Cox appropriate hazard pattern. Results: Symptom of ileus and abdominal abscess appeared more frequently in the non-EIPL group(p<0.05). The overall survival (OS) curve and the recurrence free survival (RFS) curve of the EIPL group was better than the non-EIPL group (p<0.05). The EIPL, tumor size, vascular invasion, N stage and T stage were independent prognostic factors of overall survival. The independent risk factors of recurrence free survival (RFS) include EIPL and tumor size. Conclusions: The present study revealed that EIPL can reduce the possibility of perioperative complications including ileus and abdominal abscess. Besides, the overall survival curve and recurrence free survival curve are better in the EIPL group. This technique is easy and not-expensive, therefore EIPL can benefit advanced gastric cancer patients a lot and would be a promising therapeutic strategy in the future.Trial Registration: Clinical Trials.gov, identifier: NCT02745509, Registered 28 March2016,https://clinicaltrials.gov/ct2/show/NCT02745509?cond=NCT02745509&draw=2&rank=1.