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Clinical trial with surgery and intraperitoneal hyperthermic perfusion for peritoneal recurrence of gastrointestinal cancer
Author(s) -
Fujimoto Shigeru,
Shrestha Ram Dhoj,
Kokubun Masashi,
Kobayashi Kokuriki,
Kiuchi Sohzaburo,
Takahashi Makoto,
Konno Chiyuki,
Ohta Masayasu,
Koike Shozo,
Kitsukawa Yukio,
Mizutani Masahiko,
Okui Katsuji
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890701)64:1<154::aid-cncr2820640126>3.0.co;2-8
Subject(s) - medicine , surgery , cancer , effusion , perfusion , anastomosis , metastasis , ovarian cancer
To treat six patients with peritoneal recurrence after radical operation for gastrointestinal cancer, an intraperitoneal hyperthermic perfusion (IPHP), combined with surgical resection of recurrent tumors, intestinal by‐pass anastomosis, or both, was carried out. Immediately after complete resection of the intraperitoneal recurrent tumors, a 2‐ to 3‐hour IPHP was performed under hypothermic general anesthesia at about 32°C, using a perfusate containing 10 μg/ml or 20 μg/ml of mitomycin C (MMC) warmed at the inflow temperature of 46.6°C to 46.9°C. The apparatus used for IPHP was designed for intraperitoneal perfusion as a closed circuit. Although five of the six patients had a malignant peritoneal effusion at the time of admission, the effusion disappeared soon after IPHP, and no cancer cell was present in the lavage from Douglas' pouch. The other patient had a recurrent tumor at the anastomotic region after low anterior resection for rectal cancer and complete resection of the recurrent tumor, combined with IPHP, was carried out. One patient with a recurrent gastric cancer died of hepatic metastasis and cancerous pleuritis 5 months after this treatment, and the other five are in good health 12.8 ± 5.1 months after IPHP. On the other hand, five patients with intra‐abdominal recurrent gastric cancer, who received only surgical treatment within the same period of time, died 3.0 ± 2.1 months after the surgery. Postoperatively, in the six patients with IPHP, transitory hepatic dysfunction, hypoproteinemia, and thrombocytopenia occurred. These results show that IPHP using MMC combined with surgery is a safe, reliable treatment for patients with peritoneal recurrence of gastrointestinal cancer.