Successful intraperitoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma

• Published in: Cancer 1999-02, Vol.85 (3), p.529-534
• Main Authors: Fujimoto, Shigeru, Takahashi, Makoto, Mutou, Takaaki, Kobayashi, Kokuriki, Toyosawa, Tadashi
• Format: Article
• Language: English
• Subjects: Antineoplastic agents; Biological and medical sciences; Carcinoma - prevention & control; Carcinoma - secondary; Carcinoma - surgery; Carcinoma - therapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Female; gastric carcinoma; Gastric Lavage - methods; Humans; Hyperthermia, Induced - methods; intraperitoneal hyperthermic chemoperfusion; Male; Medical sciences; Middle Aged; Neoplasm Staging; Peritoneal Lavage - methods; Peritoneal Neoplasms - prevention & control; Peritoneal Neoplasms - secondary; peritoneal recurrence; Pharmacology. Drug treatments; Prospective Studies; Recurrence; Stomach; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach Neoplasms - therapy; surgery; Survival Rate
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19990201)85:3<529::AID-CNCR3>3.0.CO;2-9

BACKGROUND The majority of advanced gastric carcinoma patients with serosal invasion die of peritoneal recurrence, even when a curative gastrectomy is performed, because peritoneal recurrence occurs due to intraperitoneal free tumor cells that detach from the serosal‐invaded focus. In an attempt to prevent peritoneal recurrence, intraperitoneal hyperthermic chemoperfusion (IHCP) treatment was combined with aggressive surgery. METHODS Between March 1987 and December 1996, 141 gastric carcinoma patients with macroscopic serosal invasion were allocated randomly to 2 groups. Seventy‐one patients underwent IHCP combined with surgery (IHCP group) and the remaining 70 patients underwent surgery alone (control group). IHCP was performed just after gastric resection and alimentary tract reconstruction under general anesthesia along with systemic hyperthermia. RESULTS Postoperative complications were reported in 2 of the 71 patients in the IHCP group and in 2 of the 70 patients in the control group. The peritoneal recurrence rate in the IHCP group was significantly decreased (P = 0.0000847) compared with that in the control group. The 2‐year, 4‐year, and 8‐year survival rates for the IHCP group were 88%, 76%, and 62%, respectively, whereas those for the control group were 77%, 58%, and 49%, respectively. The IHCP group thus reaped a significant survival benefit (P = 0.0362) compared with the control group. CONCLUSIONS Although this study was conducted randomly for a small number of patients, compared with the control group, the IHCP group had a high survival rate and better prognosis. Cancer 1999;85:529–34. © 1999 American Cancer Society. Seventy‐one gastric carcinoma patients with serosal invasion were treated with intraperitoneal hyperthermic chemoperfusion combined with surgery. The survival rate of these 71 patients was significantly higher than that of the control group of 70 patients who were treated with surgery alone.