Early postoperative intraperitoneal chemotherapy for macroscopically serosa-invading gastric cancer patients

Peritoneal recurrence is one of the most common patterns of recurrence after gastric cancer surgery and it has a poor prognosis despite all efforts. The aim of this study is to evaluate the prognostic impact of early postoperative intraperitoneal chemotherapy (EPIC) after surgery with curative intent for macroscopically serosa-invading gastric cancer patients.

The records of 245 patients under the age of 70 were reviewed. These patients were suffering from macroscopically seroa-invading gastric cancer and they underwent curative surgery from 1995 to 2004 at the Kyungpook National University Hospital, Daegu, Korea. The overall survival, gastric cancer-specific survival, complications, and patterns of recurrence were compared between the patients who were treated with EPIC and those who were not.

EPIC was administered to 65 patients, and the remaining 180 patients did not receive this treatment. The 5-year overall and gastric cancer-specific survival rates for the EPIC group were 47.4% and 53.1%, respectively, and those for the non-EPIC group were 26.7% and 29.7%, respectively (p=0.012 for overall survival and p=0.011 for gastric cancer-specific survival). The rates of peritoneal recurrence for the EPIC group and the non-EPIC group were 18.5% and 32.2%, respectively (p=0.038). There were no significant differences in the morbidity or mortality between the two groups. Based on a multivariate analysis of the factors with prognostic significance in univariate analyses, EPIC, pathological lymph node metastasis, differentiation, and the extent of gastric resection were independent prognostic factors.

The use of EPIC to treat gastric cancer patients with macroscopic serosal invasions resulted in better survival rate by reducing the risk of peritoneal recurrence.