[Prophylaxis and treatment of peritoneal metastasis from gastric cancer]

Between 1976 and 1984, 234 patients with advanced gastric cancer (pT3, pT4) were curatively gastrectomized and intraperitoneal free cancer cells which were detected by lavave of the Douglas cavity were recognized in 17.8% of the patients with pT3 and 25.0% of those with pT4. Even if curative surgery was performed for patients with free cancer cells, their five-year survival rate was very poor. The five-year survival rate was very poor. The five-year survival of patients with curatively operated gastric cancer without free cancer cells was 49.3%, whereas that of patients with free cancer cells was significantly lower (15.4%). Then the results of treatment for patients with free cancer cells were analyzed in regard to the effect of continuous hyperthermic peritoneal perfusion (CHPP) as prophylaxis of peritoneal metastasis. Five-year survival rate in the patients treated with CHPP was 33.3% and it was only 4.2% in the controls. In patients without intraperitoneal free cancer cells, however, no difference was observed in the five-year survival rates between those patients who had been treated with CHPP and the controls. Therefore, it is reasonable to assume that CHPP can be effective in preventing peritoneal recurrence of resected gastric cancer that is positive for free cancer cells in the peritoneal cavity and peritoneal micrometastasis.