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KMID : 0371319970520020196
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Journal of the Korean Surgical Society
1997 Volume.52 No. 2 p.196 ~ p.205
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The Clinical Experiences of Continuous Hyperthermic Peritoneal Perfusion in Advanced Gastric Cancer
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Abstract
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One of the major problem after surgery for gastric cancer than invades the gastric serosa is a peritoneal metastasis. Despite the recent advances in anti-cancer chemotherapy no satistactory treatment is established for peritoneal metastasis. In
1980s,
hyperthermia therapy was introduced, because hyperthermia has a direct anti-cancer effect and synergistic effect with some kinds of anticancer drugs. We investigated 101 advanced gastric cancer patients who exhibited serosal invasion in gross,
twenty
three patients were treated by continuous hyperthermic peritoneal perfusion(CHPP) combined with surgery from Feb. 1993 to Nov. 1994 and 78 patients of control group underwent surgical treatment only at the same period.
@ES The results are as follows;
@EN 1) The ratio of peritoneal seeding was higher in CHPP group(P<0.05).
2) The ratio of metastatic lymph nodes to total dissected lymph nodes above 30% was higher in CHPP group(P=0.02).
3) In comparison of the type CHPP group showed higher incidence of Borrmann type IV(P<0.05).
4) In comparison of the type of operation, CHPP group underwent high ratio of total gastrectomy (P<0.05)
5) Cancer cells in the preoperative peritoneal irrigation fluid were positive in 6 cases but these floating cancer cells were disappeared after CHPP in all cases.
6) The postoperative courses of CHPP group were precise those of control group.
7) There was no case of perioperative mortality.
8) The cases of peritoneal metastasis in CHPP group showed higher survival ratio than in control group significantly(P=0.02).
These results show that CHPP using chemotherapeutic agent combined with surgery is a relatively safe and reliable treatment or prophylactic method of peritoneal metastasis in advance gastric cancer with peritoneal seeding or with serosal invasion
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KEYWORD
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