Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis

Peritoneal metastasis (PM) is a major challenge in advanced gastric cancer (GC) with poor prognosis. Normothermic intraperitoneal and systemic treatment (NIPS) has become a promising therapeutic approach. This consensus aims to provide practical recommendations for NIPS treatment for gastric cancer with peritoneal metastasis (GCPM). The GRADE standards were used to rank evidence, and the Delphi method was employed for expert voting. 30 experts from China, Japan, South Korea, and Singapore participated in the development of this consensus. 28 experts participated in the voting process, which produced 29 statements covering diagnostic approaches, patient selection criteria, treatment regimens, management of intraperitoneal port placement, and conversion surgery considerations, and post-surgical treatment strategies in NIPS therapy. Based on current evidence and expert experience, these statements aim to improve the clinical outcomes of NIPS therapy for GCPM patients.