Efficacy of continuous hyperthermic peritoneal perfusion for the prophylaxis and treatment of peritoneal metastasis of advanced gastric cancer: Evaluation by multivariate regression analysis

Thirty-two patients with advanced gastric cancer underwent continuous hyper thermic peritoneal perfusion (CHPP) combined with surgery: to prevent perit oneal recurrence in 15 patients without peritoneal metastasis (prophylactic CHPP) and to treat 17 patients with peritoneal metastases (therapeutic CHP P). The postoperative outcome was compared with that of control patients tr eated with surgery alone. Peritoneal recurrence was less frequent (26%) and the 5-year survival rate was significantly higher (39%) in the patients wi th prophylactic CHPP than in 40 control patients (42 and 17%, respectively) . The patients with therapeutic CHPP showed significantly better median sur vival than did 20 control patients (11 vs. 6 months). Cox multivariate regr ession analysis revealed that CHPP was an independent prognostic factor in the prophylactic study (hazard ratio = 0.3965), and that the independent pr ognostic factor in the therapeutic study was not CHPP but complete resectio n of the peritoneal metastasis. Thus, CHPP has no marked benefit for establ ished peritoneal metastasis, CHPP for the prevention of peritoneal recurren ce may have a beneficial effect on long-term survival, but a prospective ra ndomized trial is needed to clarify its prognostic value.