title: Laparoscopic Hyperthermic Intraperitoneal Perfusion Chemotherapy for Patients with Malignant Ascites Secondary to Unresectable Gastric Cancer.
abstract: BACKGROUND
  To compare the efficacy of three chemotherapeutic combinations for laparoscopic hyperthermic intraperitoneal perfusion chemotherapy (HIPPC) in the treatment of malignant ascites secondary to unresectable gastric cancer (GC).
  
  
  METHODS
  From January 2010 to December 2013, 38 GC patients were randomly divided into three groups and treated by laparoscopic HIPPC with one of the three following chemotherapy combinations: raltitrexed (Ra) with oxaliplatin [trans-(±)-diaminocyclohexane oxalatoplatinum (l-OHP)], Ra with cisplatin (DDP), and Ra with mitomycin C (MMC). Perioperative complications, patients' quality of life, and survival were recorded and compared among the three groups.
  
  
  RESULTS
  The intraoperative course was successful in all patients, and no perioperative death or complication related to laparoscopic HIPPC was documented. The median follow-up period was 9 months, and the median survival was 7.5 months for all patients. Patients in the Ra/l-OHP group had a median survival of 8.7 months, the Ra/DDP group had a median survival of 5.6 months, and the Ra/MMC group had a median survival of 7.5 months. Patients' median survival in the Ra/l-OHP group and Ra/MMC group was significantly longer than in the Ra/DDP group (P < .05). No significant difference was found in total remission rate of ascites, increase in the Karnofsky Performance Scale, and incidence rate of port-site metastases among the three groups.
  
  
  CONCLUSIONS
  Laparoscopy-assisted HIPPC provides modest yet encouraging efficacy for malignant ascites secondary to disseminated GC. Our preliminary data indicate that the chemotherapeutic combination of Ra/l-OHP and Ra/MMC might be more beneficial compared with Ra/DDP in terms of patients' survival.
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Ming-Chen
authors.initials: MC
authors.lastname: Ba
authors.affiliation: 2 Department of Pharmacy, Guangzhou Dermatology Institute , Guangzhou, People's Republic of China .
authors.forename: Hui
authors.initials: H
authors.lastname: Long
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Xiang-Liang
authors.initials: XL
authors.lastname: Zhang
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Yuan-Feng
authors.initials: YF
authors.lastname: Gong
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Yun-Qiang
authors.initials: YQ
authors.lastname: Tang
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Yin-Bing
authors.initials: YB
authors.lastname: Wu
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Fei-Hong
authors.initials: FH
authors.lastname: Yu
authors.affiliation: 1 Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical University , Guangzhou, People's Republic of China .
authors.forename: Shu-Zhong
authors.initials: SZ
authors.lastname: Cui
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001201:Ascites / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D002277:Carcinoma / Q000150:complications / Q000556:secondary* / Q000628:therapy; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents