title: Relationship between the long-term effects of intraperitoneal chemotherapy and the expression of p53 and p21 in patients with gastric carcinoma at stage IIIa and stage IIIb.
abstract: BACKGROUND
  The relationship between the expression of p53 and p21 in cases of advanced gastric cancer (t3) with lymph node metastasis [n1(+) or n2 (+)] and the long-term effects of continuous hyperthermic peritoneal perfusion (CHPP) immediately after resection was evaluated.
  
  
  METHODS
  Between 1983 and 1989, 74 patients with gastric cancer [t3, n1(+) or n2(+)] underwent curative gastrectomy and survived without postoperative complications. These patients were followed up for at least six years.
  
  
  RESULTS
  Thirty-seven patients died from recurrence of cancer. In 34 patients who had tumors designated p53-/p21+ or p53+/p21+, CHPP reduced the percentage of patients who died from recurrence of cancer from 10/20 (50%) to 3/14 (21.4%, P = 0.184). However, in 40 patients who had tumors designated p53-/p21- or p53+/p21-, the percentage of patients who were treated with or without CHPP and died from recurrence of cancer was the same, 6/10 (60%) and 18/30 (60%). In the case of patients who had p21-positive tumors, the 5-year survival rate of 11 patients who were treated with CHPP (72.7%) was higher than that of 17 patients who were not treated with CHPP (41.2%, p = 0.027). However, in the case of patients with p21-negative tumors, the 5-year survival rate of 10 patients who were treated with CHPP (50%) was not very different from that of 28 patients who were not treated with CHPP (42.9%, p = 0.308).
  
  
  CONCLUSIONS
  These results indicate that the CHPP might be effective in preventing the recurrence of cancer in patients with p21-positive regardless of the expression of p53.
authors.affiliation: Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ikeguchi
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Katano
authors.forename: Y
authors.initials: Y
authors.lastname: Gomyo
authors.forename: S
authors.initials: S
authors.lastname: Tsujitani
authors.forename: M
authors.initials: M
authors.lastname: Maeta
authors.forename: N
authors.initials: N
authors.lastname: Kaibara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015689:Oncogene Protein p21(ras) / Q000096:biosynthesis*; D011897:Random Allocation; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*
chemical_list: D000970:Antineoplastic Agents; D016159:Tumor Suppressor Protein p53; D015689:Oncogene Protein p21(ras)