IMPROVED MORTALITY-RATE OF GASTRIC-CARCINOMA PATIENTS WITH PERITONEALCARCINOMATOSIS TREATED WITH INTRAPERITONEAL HYPERTHERMIC CHEMOPERFUSION COMBINED WITH SURGERY

BACKGROUND. Peritoneal carcinomatosis from gastric carcinoma has a ver y poor prognosis. The purpose of this study was to evaluate the effica cy of intraperitoneal hyperthermic chemoperfusion (IHCP) in advanced g astric carcinoma patients with peritoneal carcinomatosis. METHODS. IHC P combined with aggressive surgery was performed in as gastric carcino ma patients with peritoneal carcinomatosis; 18 gastric carcinoma patie nts with peritoneal carcinomatosis serving as controls were treated wi th surgery alone. RESULTS. The survival period was extended for the 48 patients who underwent surgery plus IHCP compared with the control pa tients (P = 0.00167). Of the 29 patients with peritoneal carcinomatosi s in the upper abdominal cavity, the 21 patients treated with IHCP and surgery had survival periods superior to those of the 8 patients trea ted by surgery alone (P = 0.000817). The 5-year survival rate ci the 1 8 IHCP patients with countable metastases in the entire cavity was 41. 6%, whereas the 50% survival duration of tbe control group was 110 day s. Nineteen patients with numerous metastases in the entire cavity die d within 673 days, regardless of whether or not IHCP was used. CONCLUS IONS. Peritoneal carcinomatosis is not a disease beyond treatment. IHC P treatment combined with extensive surgery provides an effective and practical method of treating this disease entity. (C) 1997 American Ca ncer Society.