Intraperitoneal cisplatin during surgery for gastric cancer and peritoneal seeding

Forty-five patients with gastric cancer having peritoneal seeding but no liver metastases received intraperitoneal cisplatin, 50 to 200 mg (89.4 mg on average), immediately after gastrectomy, while 37 controls were treated with intravenous mitomycin C on the day of their gastrectomy and daily oral tegafur (N1-(2'-tetrahydrofuryl)-5-fluorouracil) postoperatively. Side effects and postoperative complications after intraperitoneal cisplatin were limited. The postoperative survival rate was better in patients given cisplatin than in the controls (P < 0.05). A significant difference in survival was seen particularly in those with the undifferentiated type of gastric cancer or 'massive' peritoneal seeding. The succinate dehydrogenase inhibition test for chemosensitivity to drugs revealed that tissues obtained from the undifferentiated type of gastric cancer or foci of peritoneal seeding were more sensitive to cisplatin than to mitomycin C or adriamycin. These results demonstrate that intraperitoneal cisplatin after gastrectomy is safe and suitable for the treatment of patients with gastric cancer and peritoneal seeding.