[Application study on regional infusion chemotherapy by celiac trunk during operation in advanced gastric cancer patients].
OBJECTIVE
To explore the feasibility, safety and efficacy of intraoperative regional infusion chemotherapy by celiac trunk in advanced gastric cancer patients.


METHODS
One hundred and twenty-six patients with advanced gastric cancer(stageII(-III() were screened from database of Gastrointestinal Surgery Department of Taizhou People's Hospital between January 2008 and December 2010 who underwent R0 resection and D2 lymphadenectomy, received postoperative chemotherapy(XELOX or FOLFOX), and had complete follow-up data. They were divided into infusion chemotherapy group (65 cases) and control group (61 cases) according to regional infusion chemotherapy or not (fluorine 1 000 mg and cisplatin 60 mg). The side effects of chemotherapy, parameters related to the operation, long-term survival and relapse rate were compared between the two groups.


RESULTS
The baseline data between the two groups were comparable(all P>0.05). Postoperative III( and IIII( adverse reaction of chemotherapy was not significantly different between the two groups (P>0.05). The time of postoperative intestinal function recovery [(67.9±14.8) hours vs. (68.9±15.0) hours, t=-0.380, P=0.705), volume of postoperative 1-week drainage [(66.1±17.1) ml vs.(61.9±18.2) ml, t=1.478, P=0.142], recent morbidity of complications[55.4%(36/65) vs. 49.2%(30/61), χ2=0.256, P=0.613], and the long-term morbidity of complications [16.9% (11/65) vs. 14.8% (9/61), χ2=0.111, P=0.739] were all not significantly different between the two groups. The 3-year survival rate and 3-year relapse-free survival rate in infusion chemotherapy group were significantly higher than those in control group(58.4% vs. 37.7%, χ2=5.382, P=0.020; 58.4% vs. 34.4%, χ2=6.636, P=0.010).


CONCLUSIONS
Regional infusion chemotherapy by celiac trunk during operation for advanced gastric cancer patients is safe and feasible, and can reduce the risk of local recurrence and improve survival rate.
Department of General Surgery, The First Hospital of Soochow University, Suzhou 215006, China.
Xiaolan
X
You
Department of General Surgery, The First Hospital of Soochow University, Suzhou 215006, China. qianhaixinl@hotmail.com.
Haixin
H
Qian
Department of General Surgery, The First Hospital of Soochow University, Suzhou 215006, China.
Lei
L
Qin
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Yuanjie
Y
Wang
Department of Quality Control, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Wenqi
W
Li
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Yanjun
Y
Lian
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Xiaojun
X
Zhao
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Ning
N
Xu
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Chuanjiang
C
Huang
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Zhiyi
Z
Chen
Department of Gastrointestinal Surgery, Taizhou People's Hospital, Jiangsu Taizhou 225300, China.
Guiyuan
G
Liu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine; D002445:Celiac Artery; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality*; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005461:Fluorine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D005743:Gastrectomy; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D010071:Oxaloacetates; D011183:Postoperative Complications; D020127:Recovery of Function; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate
D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D000077150:Oxaliplatin; D003841:Deoxycytidine; D005461:Fluorine; D000069287:Capecitabine; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil