Improved mortality rate of gastric carcinoma patients with peritoneal carcinomatosis treated with intraperitoneal hyperthermic chemoperfusion combined with surgery

• Published in: Cancer Vol. 79; no. 5; pp. 884 - 891
• Main Authors: Fujimoto, Shigeru, Takahashi, Makoto, Mutou, Takaaki, Kobayashi, Kokuriki, Toyosawa, Tadashi, Isawa, Eiji, Sumida, Megumi, Ohkubo, Haruo
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.03.1997; Wiley-Liss
• Subjects: Antineoplastic agents; Biological and medical sciences; Carcinoma - drug therapy; Carcinoma - secondary; Carcinoma - surgery; Carcinoma - therapy; Combined Modality Therapy; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Female; gastric carcinoma; Humans; Hyperthermia, Induced; intraperitoneal hyperthermic chemoperfusion; Male; Medical sciences; Middle Aged; Mitomycin - administration & dosage; Neoplasm Metastasis; peritoneal carcinomatosis; Peritoneal Neoplasms - drug therapy; Peritoneal Neoplasms - secondary; Pharmacology. Drug treatments; Stomach; Stomach Neoplasms - drug therapy; Stomach Neoplasms - surgery; Stomach Neoplasms - therapy; survival; Survival Analysis; Antineoplastic agent; Human; Regional treatment; Stomach; Intraperitoneal administration; Carcinoma; Mitomycin; Carcinosis; Malignant tumor; Survival; Result; Chemotherapy; Surgery; Digestive diseases; Advanced stage; Combined treatment; Induced hyperthermia; Gastric disease; Peritoneum
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19970301)79:5<884::AID-CNCR3>3.0.CO;2-C

BACKGROUND Peritoneal carcinomatosis from gastric carcinoma has a very poor prognosis. The purpose of this study was to evaluate the efficacy of intraperitoneal hyperthermic chemoperfusion (IHCP) in advanced gastric carcinoma patients with peritoneal carcinomatosis. METHODS IHCP combined with aggressive surgery was performed in 48 gastric carcinoma patients with peritoneal carcinomatosis; 18 gastric carcinoma patients with peritoneal carcinomatosis serving as controls were treated with surgery alone. RESULTS The survival period was extended for the 48 patients who underwent surgery plus IHCP compared with the control patients (P = 0.00167). Of the 29 patients with peritoneal carcinomatosis in the upper abdominal cavity, the 21 patients treated with IHCP and surgery had survival periods superior to those of the 8 patients treated by surgery alone (P = 0.000817). The 5‐year survival rate of the 18 IHCP patients with countable metastases in the entire cavity was 41.6%, whereas the 50% survival duration of the control group was 110 days. Nineteen patients with numerous metastases in the entire cavity died within 673 days, regardless of whether or not IHCP was used. CONCLUSIONS Peritoneal carcinomatosis is not a disease beyond treatment. IHCP treatment combined with extensive surgery provides an effective and practical method of treating this disease entity. Cancer 1997; 79:884‐91. © 1997 American Cancer Society. Forty‐eight gastric carcinoma patients with peritoneal carcinomatosis were treated with intraperitoneal hyperthermic chemoperfusion (IHCP) combined with surgery. The survival rate of the 46 patients treated with IHCP and surgery was significantly superior to that of the 18 patients treated with surgery alone.