PROPHYLAXIS WITH INTRAOPERATIVE CHEMOHYPERTHERMIA AGAINST PERITONEAL RECURRENCE OF SEROSAL INVASION-POSITIVE GASTRIC-CANCER

Continuous hyperthermic peritoneal perfusion (CHPP) with a solution wh ich contains 30 mg mitomycin C and 300 mg cisplatin has been introduce d as a prophylactic treatment for peritoneal recurrence after curative resection of 79 advanced gastric cancers. The control group consisted of 81 patients with advanced gastric cancer who underwent curative su rgery during the same period. CHPP was performed for 60 minutes by per fusing MMC- and CDDP-containing saline solutions warmed at 43.5 degree s C by a special CHPP device. In patients with pathologically confirme d serosal invasion-positive tumors, the survival rate of the CHPP grou p was significantly higher than that of the control group. A survival advantage for stage IV patients was also obtained by CHPP. However, th ere was no survival advantage between the CHPP group and the control g roup with serosal invasion-negative tumors. Adverse effects were obser ved in four patients who underwent CHPP: One developed severe bone mar row suppression, and transient hyperazotemia was observed in the other three. There was no difference in the incidence of mortality and morb idity between the two groups. These results indicate that CHPP is a sa fe, readily available prophylactic therapy for peritoneal recurrence a fter gastric cancer surgery.