Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding.
Fifteen patients with far-advanced gastric cancer were given surgical treatment followed by intraperitoneal hyperthermic perfusion (IPHP) with mitomycin C (MMC) and misonidazole (MIS), a thermosensitizing drug. Immediately after extensive resection of the abdominal tumors, a 2-hour IPHP was performed at the inflow temperature of 44.7 to 48.7 C, using equipment designed for treatment of cancerous peritoneal seeding as a closed circuit, and under hypothermic general anesthesia at 30 to 31 C. In nine of the 15 patients with peritoneal seeding and/or ascites, cancerous ascites was absent after this treatment. In all cases, repeated cytologic examinations of the lavage from Douglas's pouch were negative. The postoperative courses were uneventful except for Patients 1 and 10, in whom slight leakage occurred. All patients were discharged and are in good health at the time of this writing, 7.2 +/- 4.6 months after the treatment. The Case 4 Patient recently died in a traffic accident. In all patients, transient hepatic dysfunction and hypoproteinemia occurred after the operation. This extensive surgery combined with IPHP using MMC and MIS was well tolerated and is a safe antitumor treatment for gastric cancer with peritoneal dissemination. Neurotoxicity due to MIS was nil.
D000328:Adult; D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D008920:Misonidazole / Q000008:administration & dosage; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage / Q000097:blood; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D013274:Stomach Neoplasms / Q000601:surgery / Q000628:therapy*
D008937:Mitomycins; D016685:Mitomycin; D008920:Misonidazole