title: Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Final results of a randomized controlled study.
abstract: BACKGROUND
  Continuous hyperthermic peritoneal perfusion (CHPP) with a solution that contained 10 micrograms/ml mitomycin C was devised initially as a method for intraperitoneal thermochemotherapy. The authors conducted a randomized clinical trial to evaluate the efficacy of CHPP as a prophylactic treatment for prevention of peritoneal recurrence of gastric cancer with serosal invasion.
  
  
  METHODS
  Between January 1983 and October 1986, 82 patients with gross serosal invasion but no gross peritoneal metastasis were divided by random sampling into two groups before undergoing potentially curative surgery for gastric cancer: 42 patients were scheduled to receive CHPP, whereas 40 were not scheduled to receive this treatment. CHPP was administered immediately after closing the abdomen after gastric resections while the patients were still on the operating table under general anesthesia.
  
  
  RESULTS
  The 5-year survival rate (64.2%) of patients in the CHPP group was higher than that (52.5%) of patients in the control group although the difference was not significant. Of several patterns of cancer recurrence, peritoneal recurrence was more frequent in the control group than in the CHPP group. The mortality rate from peritoneal recurrence in the case of patients in the CHPP group was much lower than that of patients in the control group (P = 0.0854). CHPP did not induce anastomotic breakdown or chemical peritonitis after surgery.
  
  
  CONCLUSIONS
  The results indicate that CHPP is effective in preventing peritoneal recurrence of gastric cancer with serosal invasion, which is highly likely to reappear in the peritoneum.
authors.affiliation: First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Hamazoe
authors.forename: M
authors.initials: M
authors.lastname: Maeta
authors.forename: N
authors.initials: N
authors.lastname: Kaibara
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy; D010477:Perfusion; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy; D010976:Platelet Count / Q000187:drug effects; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000628:therapy*
chemical_list: D016685:Mitomycin