title: Treatment of peritoneal dissemination from gastric cancer by peritonectomy and chemohyperthermic peritoneal perfusion.
abstract: BACKGROUND
  There is no standard treatment for peritoneal dissemination from gastric cancer. A novel treatment consisting of peritonectomy and intraoperative chemohyperthermic peritoneal perfusion (CHPP) was compared with conventional surgery and CHPP.
  
  
  METHODS
  Records of all patients who underwent CHPP after cytoreductive surgery between 1992 and 2002 were reviewed.
  
  
  RESULTS
  Data for 107 patients with peritoneal dissemination were available. Complete cytoreduction was achieved in 47 (43.9 per cent) of the 107 patients: 18 of 65 who underwent conventional surgery and 29 of 42 who had peritonectomy. Twenty-three patients (21.5 per cent) suffered from complications. The overall operative mortality rate was 2.8 per cent. Seventeen patients (15.9 per cent) were disease free and 87 subsequent deaths were related to disease progression. The median survival for all patients was 11.5 months, with a 5-year survival rate of 6.7 per cent. Median survival after complete cytoreduction was 15.5 months and that after incomplete cytoreduction was 7.9 months, with 5-year survival rates of 13 and 2 per cent respectively. Completeness of cytoreduction and peritonectomy were independent prognostic factors. The 5-year survival rate after complete cytoreduction by peritonectomy with CHPP was 27 per cent.
  
  
  CONCLUSIONS
  Complete cytoreduction after peritonectomy and CHPP may improve the survival of patients with peritoneal dissemination from gastric cancer.
authors.affiliation: Peritoneal Dissemination Programme, Shizuoka Cancer Centre, 1007 Shimo-nagakubo, Nagaizumi-machi, Suntougun, Shizuoka 411-8777, Japan. y.yonemura@scchr.p
authors.forename: Y
authors.initials: Y
authors.lastname: Yonemura
authors.forename: T
authors.initials: T
authors.lastname: Kawamura
authors.forename: E
authors.initials: E
authors.lastname: Bandou
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Sawa
authors.forename: N
authors.initials: N
authors.lastname: Matsuki
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D013274:Stomach Neoplasms / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis
chemical_list: D016685:Mitomycin; D005047:Etoposide; D002945:Cisplatin