From local eradication to immune priming: Paradigm shift of hyperthermic intraperitoneal chemotherapy in gastric cancer therapy

doi:10.3748/wjg.v32.i17.118346

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May 7, 2026 (publication date) through Apr 24, 2026

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. May 7, 2026; 32(17): 118346
Published online May 7, 2026. doi: 10.3748/wjg.v32.i17.118346

From local eradication to immune priming: Paradigm shift of hyperthermic intraperitoneal chemotherapy in gastric cancer therapy

Chun-Xiao Ni, Jia-Ju Xu

Chun-Xiao Ni, Department of Minimally Invasive Oncology, Tai’an City Central Hospital, Tai’an 271000, Shandong Province, China

Jia-Ju Xu, Department of Medical Oncology, Tai’an City Central Hospital, Tai’an 271000, Shandong Province, China

Co-first authors: Chun-Xiao Ni and Jia-Ju Xu.

Author contributions: Xu JJ was responsible for the manuscript’s intellectual direction, from the initial overall concept and outline to the specific discussion; Ni CX and Xu JJ made equal contributions to this work, played essential roles in the critical stages of manuscript preparation, contributed to this paper, the writing, editing the manuscript, and review of literature as co-first authors; all of the authors read and approved the final version of the manuscript to be published.

Supported by Scientific Research Fund of Tai’an Science and Technology Agency, No. 2019NS180.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

Corresponding author: Jia-Ju Xu, MD, Department of Medical Oncology, Tai’an City Central Hospital, No. 29 Longtan Road, Tai’an 271000, Shandong Province, China. jiajuxu1101@163.com

Received: December 30, 2025
Revised: January 13, 2026
Accepted: February 5, 2026
Published online: May 7, 2026
Processing time: 115 Days and 16.5 Hours

Core Tip

Core Tip: Postoperative hyperthermic intraperitoneal chemotherapy should be reconceptualized as an immunogenic primer that activates systemic anti-tumor immunity, rather than be viewed merely as a local cytoreductive treatment. This repositions hyperthermic intraperitoneal chemotherapy as a strategic foundation for synergistic combination with immune-checkpoint inhibitors. Consequently, future research should prioritize the definition of optimal synergistic sequences and the identification of predictive biomarkers to pave the way for this precision immunotherapy strategy.