HIPEC FOR GASTRIC CANCER PERITONEAL DISEASE
CHINA'S LARGEST ASIAN PROGRAMME

China accounts for approximately 45% of global gastric cancer cases. This epidemiological reality has driven the development of the world's largest surgical oncology infrastructure for stomach cancer — including the most active HIPEC programmes for peritoneal disease.

“Disease burden drives expertise. China sees more gastric cancer with peritoneal disease than any other region — and its surgical oncology programmes have responded with depth and scale that no other system matches.”

• Highest Global Disease Burden

  Approximately 480,000 new gastric cancer cases are diagnosed annually in China — nearly half of the global total. Peritoneal disease develops in 14–43% of patients at some point in the disease course, creating a uniquely high demand for HIPEC-capable surgical oncology services.

• Decades of Programme Development

  Major Chinese cancer centres — including the Cancer Hospital of the Chinese Academy of Medical Sciences in Beijing, Fudan University Shanghai Cancer Center, and Sun Yat-sen University Cancer Center in Guangzhou — have run gastric HIPEC programmes for over 15 years, with combined annual volumes exceeding any other Asian nation.

The Yang trial — conducted by Xiao-Jun Yang and colleagues at Wuhan and Beijing, published in Annals of Surgical Oncology in 2011 — provided the most important Chinese randomised evidence for CRS + HIPEC in advanced gastric cancer with peritoneal disease.

• Phase III RCT in Synchronous Peritoneal Disease

  68 patients with gastric cancer and synchronous peritoneal carcinomatosis were randomised to CRS alone vs CRS + HIPEC. The trial focused on the population with established peritoneal disease — exactly the group where Western evidence had been most limited.

• HIPEC Regimen: Cisplatin + Mitomycin C

  The HIPEC arm received heated cisplatin (120 mg) and mitomycin C (30 mg) at 43°C for 60–90 minutes immediately after maximal cytoreductive surgery. This combination drug protocol was specifically developed in Chinese practice and continues to be used widely today.

• Primary Endpoint: Median Overall Survival

  Median overall survival improved from 6.5 months in the CRS-alone arm to 11.0 months in the CRS + HIPEC arm. The hazard ratio favoured the HIPEC group (HR 0.60, 95% CI 0.27–0.96), establishing meaningful survival benefit in a population that historically had very poor outcomes.

• Subsequent Chinese Series Confirmed Benefit

  Multiple subsequent Chinese single-centre and multi-centre series have reinforced the Yang findings. Modern Chinese protocols increasingly combine HIPEC with neoadjuvant systemic chemotherapy, immunotherapy (anti-PD-1), and laparoscopic approaches at high-volume centres.

Survival data from the foundational Yang trial alongside other major international evidence.

Standard protocols at major Chinese cancer centres for the main clinical scenarios.

Chinese gastric cancer programmes are distinctive for integrating HIPEC with neoadjuvant chemotherapy, immune checkpoint inhibitors, and supportive Traditional Chinese Medicine — producing a multi-modal care model not commonly available outside Asia.

• Neoadjuvant Systemic Chemotherapy

  Most gastric peritoneal cancer protocols at Chinese centres begin with 3–4 cycles of systemic chemotherapy (typically SOX, XELOX, or FLOT regimens) before considering CRS + HIPEC. This tests tumour biology, controls systemic disease, and may convert unresectable disease to resectable.

• Immunotherapy Combination

  Sintilimab, tislelizumab, and other Chinese-developed PD-1 inhibitors are increasingly combined with chemotherapy in HER2-negative gastric cancer protocols. Several Chinese centres deliver immunotherapy before and after CRS + HIPEC, particularly in PD-L1 positive or MSI-high tumours.

• Traditional Chinese Medicine (TCM) Support

  Many Chinese cancer centres integrate TCM herbal formulations and acupuncture for supportive care — managing chemotherapy nausea, post-operative recovery, fatigue, and quality of life. TCM is not a replacement for HIPEC or systemic therapy but is widely used alongside it in Chinese practice.

• PIPAC: The Emerging Approach

  Pressurised Intraperitoneal Aerosol Chemotherapy (PIPAC) delivers low-dose chemotherapy as an aerosol into the abdomen during laparoscopy — used for unresectable peritoneal disease that cannot tolerate full CRS + HIPEC. Chinese centres are increasingly offering PIPAC as palliative or conversion therapy.

The practical pathway for international patients seeking gastric HIPEC at Chinese cancer centres.

1. 1

   Submit Medical Records for Review

   Recent CT/MRI, endoscopy and biopsy, surgical reports (if any), HER2 and PD-L1 status, systemic chemotherapy response, and current performance status are required.

2. 2

   Multi-Disciplinary Centre Evaluation

   Surgical oncology, medical oncology, and HIPEC specialist team review evaluate PCI, resectability, and the role of HIPEC. Selection criteria mirror international standards but adapt to Chinese protocols.

3. 3

   Visa and Travel Planning

   Medical visa coordination, hospital appointments, accommodation, and interpreter services are arranged. CancerFax coordinates end-to-end logistics for international patients.

4. 4

   CRS + HIPEC Procedure

   Single OR session: cytoreductive surgery followed by HIPEC perfusion. Typical OR time 6–10 hours. Hospital stay 10–14 days including ICU recovery.

5. 5

   Adjuvant Therapy and Discharge Planning

   Post-operative adjuvant chemotherapy and follow-up imaging schedule established. Coordination with home oncologist for continued surveillance after returning home.

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Frequently Asked Questions

Common questions about gastric cancer HIPEC programmes in China.