Prophylaxis of peritoneal carcinomatosis in experimental investigations

Background and aims: We compared the effectiveness and side effects of vari ous cytostatic agents for use in perioperative intraperitoneal irrigation t o prevent peritoneal carcinomatosis. Methods: The adenocarcinoma cell line CC-531 was implanted during laparotomy at the mesenterial trunk of anesthet ized male WAG rats. Direct perioperative intraperitoneal chemotherapy was p erformed after 5 min with either 5-fluorouracil, cisplatin, or mitomycin; c ontrols received only tumor cells. The animals were inspected daily over 30 days for side effects. They were then killed, and the greater omentum and mesentery were resected, the tumor mass was examined for the presence of pe ritoneal carcinomatosis, and tumor nodules in the greater omentum and mesen tery were counted. Results: All the animals in the control group developed histologically confirmed peritoneal carcinomatosis. Animals receiving cispl atin or mitomycin by direct intraperitoneal perioperative chemotherapy show ed no macroscopic or histological evidence of tumor growth. Two animals in the fluorouracil group had macroscopically and histologically manifest tumo r growth; another animal showed only histological evidence of malignancy. S ubstantial side effects were noted in the cisplatin group, with all animals experiencing bleeding in the peritoneum and toxic necrotic reactions of th e colon; two animals died of these side effects. Conclusion: Direct intrape ritoneal chemotherapy with cisplatin or mitomycin prevents peritoneal carci nomatosis in experimental investigations.