[Clinical evaluation of recurrent patterns of gastric cancer after intraperitoneal hyperthermic perfusion]

The patterns of recurrence and the prognosis of 24 gastric cancer patients with peritoneal seeding and/or serosal invasion, who underwent gastrectomy followed by intraperitoneal hyperthermic perfusion (IPHP), were studied in comparison with 23 gastric cancer patients given surgery alone (controls). With respect to 22 patients with peritoneal seeding, all of 8 patients in the control group died of re-accumulation of ascitic effusion, whereas of 14 patients in the IPHP group, 3 died of peritoneal recurrence, 2 of intraperitoneal tumors, 1 from pleural metastasis, and 1 of liver metastasis. The remaining 7 cases are alive without a sign of recurrence. Again, with respect to 25 patients with large serosal penetration of cancer, 7 of 15 patients in the controls died of peritoneal recurrence, whereas this was never observed in the IPHP group. As to the relation of histology and prognosis, while the poorly differentiated adenocarcinoma and signet ring cell carcinoma had poor prognosis in the controls, the same patterns in the IPHP group proved not to be so unfavorable. Since a few given IPHP resulted in hepatic metastasis and/or nodal involvement, adjuvant treatment will be required. The survival rate for the IPHP group was significantly better at p = 3.43 x 10(-2) than in controls.