[Extended treatment for gastric cancer patients with peritoneal seeding].
Fourteen patients with far-advanced gastric cancer were treated surgically 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 47.4 +/- 0.5 degrees C and at the outflow temperature 45.3 +/- 0.5 degrees C, using equipment designed for treatment of cancerous peritoneal seeding, as a closed circuit, and under hypothermic general anesthesia at 31.2 +/- 0.5 degrees C. In 6 of the 14 patients, cancerous ascites was absent after IPHP. Repeated cytologic examination of the lavage from pelvic cul-de-sac were negative, in all cases. The postoperative courses were uneventful except for 2 patients, in whom slight leakage occurred. All patients were discharged, and 4 in the 14 patients died of recurrence in the liver, abdominal and/or pleural cavities 8.8 +/- 2.1 months after IPHP. The remaining 10 are in good health 12.1 +/- 3.1 months after IPHP. Transient hepatic dysfunction and hypoproteinemia occurred after hyperthermia in all cases. This extensive surgery combined with IPHP using MMC and MIS was well tolerated and is a safe anti-tumor treatment for gastric cancer with peritoneal dissemination. Neurotoxicity due to MIS was nil.
Fujimoto
S
S
First Department of Surgery, School of Medicine, Chiba University, Japan.
Shrestha
R D
RD
Kokubun
M
M
Ohta
M
M
Kobayashi
K
K
Kiuchi
S
S
Okui
K
K
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D008920:Misonidazole / Q000008:administration & dosage / Q000627:therapeutic use; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage / Q000627:therapeutic use; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy; D013274:Stomach Neoplasms / Q000601:surgery*
D008937:Mitomycins; D016685:Mitomycin; D008920:Misonidazole