PREOPERATIVE INTRAPERITONEAL CHEMOTHERAPY FOR GASTRIC-CANCER, WITH SPECIAL REFERENCE TO DELAYED PERITONEAL COMPLICATIONS

Preoperative intraperitoneal (IP) chemotherapy was performed in 23 pat ients with gastric malignancies to inhibit peritoneal recurrence. Cis- diamminedichloroplatinum (CDDP) and mitomycin C (MMC) were administere d intraperitoneally 3 days prior to surgery, at which time a very visc id peritoneum and mucinous intraperitoneal fluid were found in 100% an d 83% of the patients, respectively. Inflammatory changes were microsc opically observed in the subserosal layer of the resected stomachs and in the intraperitoneal fluid, but degenerative changes characteristic of cancer cells could not be seen. The 3-year survival rate of the st age III patients was 55.6%, and peritoneal recurrence was found in thr ee of six patients with recurrence. Extensive adhesions were found in eight patients (34.8%) as a delayed peritoneal complication, and chron ic bowel obstruction resulting from the adhesion developed in five pat ients (21.7%). Thus, we conclude that the administration of this IP ch emotherapy demonstrated no definite antitumor effects or survival bene fits, but was frequently associated with delayed peritoneal complicati ons.