title: Intraperitoneal chemo-hyperthermia with mitomycin C for gastric cancer patients with peritoneal carcinomatosis.
abstract: OBJECTIVE
  This study evaluates the tolerance and efficacy of Intraperitoneal Chemo-hyperthermia (IPCH) with Mitomycin C (MMC) associated with surgery, in peritoneal carcinomatosis of gastric origin.
  
  
  BACKGROUND
  Most patients with peritoneal carcinomatosis of gastric origin die within 6 months, and IPCH associated with surgery has been reported as a possible new therapeutic approach.
  
  
  METHODS
  A prospective non randomized trial was carried out on 42 patients with gastric cancers and peritoneal carcinomatosis. Fourty-three IPCH with MMC were used as complementary treatment after surgery (peritoneal perfusate with a 10 mg/l dose of MMC, inflow temperature 46 to 49 degrees C, use of a closed circuit, duration 90 minutes). Fourteen primary tumors were unresectable ones and 12 patients had large malignant preoperative ascites.
  
  
  RESULTS
  Mortality and morbidity rates were 2/42 and 4/42 respectively. For resectable gastric cancers with stage 1 and 2 carcinomatosis (malignant granulations less than 5 mm in diameter), one, two and three year survival rates were 80, 61 and 41% respectively. For unresectable primary tumors and for stage 3 and 4 carcinomatosis (granulations larger than 5 mm in diameter), six and twelve month survival rates were 50% and 10% respectively.
  
  
  CONCLUSIONS
  IPCH appears as a safe new therapeutic approach in gastric cancers with peritoneal carcinomatosis with small malignant granulations (stage 1 and 2) and randomized trials are now needed to clearly evaluate its efficacy.
authors.affiliation: Department of Digestive Surgery, Centre Hospitalo-Universitaire Lyon-Sud, Pierre Bénite, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Sayag-Beaujard
authors.forename: Y
authors.initials: Y
authors.lastname: Francois
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.forename: B
authors.initials: B
authors.lastname: Sadeghi-Looyeh
authors.forename: J
authors.initials: J
authors.lastname: Bienvenu
authors.forename: G
authors.initials: G
authors.lastname: Panteix
authors.forename: F
authors.initials: F
authors.lastname: Garbit
authors.forename: E
authors.initials: E
authors.lastname: Grandclément
authors.forename: J
authors.initials: J
authors.lastname: Vignal
authors.forename: F N
authors.initials: FN
authors.lastname: Gilly
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral; D016685:Mitomycin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013696:Temperature
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin