{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:51:00Z","timestamp":1788389460532,"version":"build-2803163510"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peritoneal metastasis (PM) in gastric cancer (GC) correlates with a poor prognosis. PD-1 inhibitor has significantly transformed the treatment landscape for GC, but data on the combination of HIPEC with PD-1 inhibitor and systemic chemotherapy are limited. This study evaluated the efficacy and safety of this triplet therapy as first-line treatment for GC with PM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective, single-center study that included 34 advanced GC patients with PM. All patients received HIPEC combined with PD-1 inhibitor and systemic chemotherapy as first-line treatment (Nov 2021-Jun 2024). Primary endpoints were progression-free survival (PFS) and the duration of ascites control. Secondary endpoints were overall survival (OS) and adverse events (AEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median PFS was 7.8 months (range: 0.8-20.8), median OS was 14.3 months (range: 1.7-23.9). Patients diagnosed with moderate amount of ascites had significantly poorer PFS than with none or small amount of ascites (HR\u00a0=\u00a02.804,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0197). Univariable Cox regression analysis showed that age \u2264 60 years was associated with ascites progression (HR\u00a0=\u00a04.266,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02) and death (HR\u00a0=\u00a02.732,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04). Additionally, univariable Cox regression analysis showed that age \u2264 60 years (HR\u00a0=\u00a05.762,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) and moderate amount of ascites (HR\u00a0=\u00a02.923,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.027) were potential risk factors for disease progression. The most common adverse events were anemia, hypokalemia, thrombocytopenia and leukopenia. All adverse events were manageable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIPEC combined with PD-1 inhibitor and systemic chemotherapy demonstrated encouraging survival and ascites control with an acceptable safety profile in GC patients with PM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1728724","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:44:58Z","timestamp":1768196698000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The clinical significance of hyperthermic intraperitoneal chemotherapy combined with PD-1 inhibitor and systemic chemotherapy for advanced gastric cancer patients with peritoneal metastasis: a single-center retrospective 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