Intraperitoneal chemo-hyperthermia with mitomycin C for gastric cancer patients with peritoneal carcinomatosis.
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.
Sayag-Beaujard
A C
AC
Department of Digestive Surgery, Centre Hospitalo-Universitaire Lyon-Sud, Pierre Bénite, France.
Francois
Y
Y
Glehen
O
O
Sadeghi-Looyeh
B
B
Bienvenu
J
J
Panteix
G
G
Garbit
F
F
Grandclément
E
E
Vignal
J
J
Gilly
F N
FN
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
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin