INTRAPERITONEAL CHEMOHYPERTHERMIA WITH MI TOMYCIN-C FOR GASTRIC-CANCER WITH PERITONEAL CARCINOSIS

We report 42 cases of gastric cancer with peritoneal carcinosis treate d with intraperitoneal chemohyperthermia. Intraperitoneal chemohyperth ermia was achieved with a closed sterile circuit containing mytomycin C, 10 mg/l producing an input temperature varying from 46 to 49 degree s C for 90 minutes. There were three postoperative deaths : one pulmon ary embolism at day 4, one multiple organ failure et day 4, and one se ptic shock at day 25 due to a colonic fistula. Two patients suffered c omplications : one opening of the duodenal stump requiring reoperation on day 5, and one prolonged postoperative ileus lasting to day 10. Of the 12 patients with ascitis, resorption was achieved in 8. In patien ts with early-stage peritoneal carcinosis (granulations less than 5 mm ) survival at 1, 2 and 3 years was 90 %, 61 % and 41 % respectively. F or those with more extensive carcinosis, survival at 1 year was 10 %. Five patients survived more than 30 months, three have survived to 34, 43 and 73 months. Intraperitoneal chemohyperthermia is a new treatmen t for carcinosis of gastric origin. these early results must be assess ed further with larger controlled.