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Effects of continuous hyperthermic peritoneal perfusion on prognosis of gastric cancer with serosal invasion
1Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
Objective:
To evaluate the effects of continuous hyperthermic peritoneal perfusion (CHPP) together with standard chemotherapy on the prognosis of patients with gastric cancer invading the serosa.
Design:
Retrospective study.
Setting:
University hospital, Japan.
Subjects:
174 patients who had undergone curative resection for gastric cancer invading the serosa (T3) between 1980 and 1989, 78 of whom had been randomised to be treated with CHPP after operation and 96 who received standard chemotherapy.
Interventions:
CHPP was done immediately after operation; 8-10 l fluid containing 80-100 mg/m2 mitomycin C was perfused at a rate of 100-200 ml/minute, and inflow and out flow temperatures were maintained at 44-45 degrees C and 40-42 degrees C, respectively. This was followed by a standard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil (1:4) (UFT). The control group received the standard regimen only.
Main Outcome Measures:
Five year survival and patterns of recurrence in three groups: no lymph node metastases, 1-9, and 10 or more.
Results:
Only in the group with 1-9 lymph node metastases was there an appreciable but not significant difference in 5 year survival: 66% compared with 44% (p = 0.084). The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls.
Conclusion:
CHPP improved prognosis in patients with T3 gastric cancer who had only 1-9 metastatic lymph nodes.