Improved mortality rate of gastric carcinoma patients with peritoneal carcinomatosis treated with intraperitoneal hyperthermic chemoperfusion combined with surgery.
BACKGROUND
Peritoneal carcinomatosis from gastric carcinoma has a very poor prognosis. The purpose of this study was to evaluate the efficacy of intraperitoneal hyperthermic chemoperfusion (IHCP) in advanced gastric carcinoma patients with peritoneal carcinomatosis.


METHODS
IHCP combined with aggressive surgery was performed in 48 gastric carcinoma patients with peritoneal carcinomatosis; 18 gastric carcinoma patients with peritoneal carcinomatosis serving as controls were treated with surgery alone.


RESULTS
The survival period was extended for the 48 patients who underwent surgery plus IHCP compared with the control patients (P = 0.00167). Of the 29 patients with peritoneal carcinomatosis in the upper abdominal cavity, the 21 patients treated with IHCP and surgery had survival periods superior to those of the 8 patients treated by surgery alone (P = 0.000817). The 5-year survival rate of the 18 IHCP patients with countable metastases in the entire cavity was 41.6%, whereas the 50% survival duration of the control group was 110 days. Nineteen patients with numerous metastases in the entire cavity died within 673 days, regardless of whether or not IHCP was used.


CONCLUSIONS
Peritoneal carcinomatosis is not a disease beyond treatment. IHCP treatment combined with extensive surgery provides an effective and practical method of treating this disease entity.
Fujimoto
S
S
Social Insurance Funabashi Hospital, Japan.
Takahashi
M
M
Mutou
T
T
Kobayashi
K
K
Toyosawa
T
T
Isawa
E
E
Sumida
M
M
Ohkubo
H
H
D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis
D016685:Mitomycin