title: Impact of intraperitoneal chemotherapy after gastrectomy with positive cytological findings in peritoneal washings.
abstract: BACKGROUND
  There is no standard treatment available for gastric cancer patients whose sole 'non-curative factor' is positivecytological findings in peritoneal washings (CFPW). The aim of this study was to examine the safety, pharmacokinetics and efficacy for free intraperitoneal cancer cells of intraperitoneal chemotherapy with paclitaxel after gastrectomy with en bloc D2 lymph node dissection in cases of gastric cancer with positive CFPW.
  
  
  METHODS
  Ten patients with gastric cancer who underwent gastrectomy and systemic lymphadenectomy with D2 dissection, without any other non-curative factors besides positive CFPW, were treated with early postoperative intraperitoneal paclitaxel. Intra-chemotherapeutic toxicity and operative complications were measured using NCI-CTC version 3.0. Intraperitoneal and plasma paclitaxel concentrations were measured using a high-performance liquid chromatographic assay.
  
  
  RESULTS
  Grade 3/4 toxic effects included anemia (20%) and neutropenia (10%) that required no treatment. Operative complications were, for example, superficial surgical site infections (10%) that were treated with antibiotics. No viable cancer cells were observed in the intra-abdominal fluid 24 h after intraperitoneal administration of paclitaxel. The intraperitoneal/plasma area under the drug concentration-time curve ratio was 2,003.3:1.
  
  
  CONCLUSIONS
  Intraperitoneal chemotherapy with paclitaxel is a safe and effective treatment modality for free intraperitoneal cancer cells.
authors: Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. imano@med.kindai.ac.jp
authors: M
authors: M
authors: Imano
authors: H
authors: H
authors: Imamoto
authors: T
authors: T
authors: Itoh
authors: T
authors: T
authors: Satou
authors: Y F
authors: YF
authors: Peng
authors: A
authors: A
authors: Yasuda
authors: H
authors: H
authors: Kato
authors: K
authors: K
authors: Nishiki
authors: O
authors: O
authors: Shiraishi
authors: M
authors: M
authors: Shinkai
authors: M
authors: M
authors: Tsubaki
authors: T
authors: T
authors: Yasuda
authors: S
authors: S
authors: Nishida
authors: Y
authors: Y
authors: Takeyama
authors: K
authors: K
authors: Okuno
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authors: Shiozaki
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000473:pathology; D010533:Peritoneal Lavage; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents