Prophylactic Preoperative HIPEC in Advanced Gastric Cancer at High Risk of Peritoneal Recurrence

This study tests whether adding a heated chemotherapy wash of the abdominal cavity (called HIPEC) before standard stomach cancer surgery can reduce the risk of the cancer spreading to the peritoneum (the lining of the abdomen) — one of the most common and deadly sites of gastric cancer recurrence. **You may be eligible if...** - You are between 18 and 75 years old - You have confirmed advanced gastric (stomach) cancer (T3 or T4 stage) with no distant organ spread - You are medically fit for surgery - You are eligible for standard perioperative chemotherapy (FLOT4) **You may NOT be eligible if...** - Your cancer has spread to distant organs - You are over 75 years old - You have had prior major abdominal surgery (other than gallbladder or appendix removal) - You are pregnant or breastfeeding - You have another active cancer - You are not a candidate for chemotherapy Talk to your doctor to see if this trial is right for you.