The effectiveness of adjuvant intraperitoneal hyperthermic chemoperfusion after cytoreductive surgery in locally advanced gastric cancer

BACKGROUND: Intraperitoneal hyperthermic chemoperfusion (IHCP), which is a locoregional treatment used in peritoneal micrometastases in intra-abdominal tumours was first applied in 1980, and since then it has been used as an adjuvant treatment in locally advanced tumours and as palliation in inoperable tumours, especially in tumours of genital and gastrointestinal system origin.
AIM: In this study the effectiveness of adjuvant IHCP in treating gastric cancer with serosal invasion after curative surgery was investigated.
SETTING AND DESIGN: This study was designed in the Department of General Surgery in the Ankara Oncology Hospital. IHCP was done immediately after cytoreductive surgery.
METHODS: After cytoreductive surgery in 10 patients with locally advanced gastric cancer, two drains were placed into the peritoneal cavity and after the closure of the wound, IHCP was done with 10mg/L mitomycin-C at 42°C for 60-90 minutes.
RESULTS: No systemic and local complications were seen after perfusion except atelectasis in one patient. Local recurrence and metastatic tumour at the porta hepatis was seen in one patient each, hepatic metastases in five patients, and one patient died from myocardial infarction. The survival analysis was done with Kaplan-Meier method and the 1, 2, and 5-year overall and disease-free survival rates were 80, 70, 40% and 90, 60, 30% respectively.
CONCLUSION: Although this study was conducted for a small number of patients it appears that IHCP can be used safely in the adjuvant locoregional treatment of gastric cancer.