Kaibara N, Maeta M, Hamazoe R, Inoue Y, Koga S
1st Dept. of Surgery, Tottori University School of Medicine.
Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-2):1269-72.
In approximately 80% of patients with scirrhous carcinoma of the stomach, recurrence of cancers occurs even after potentially curative resection, and recurrence most frequently occurs in the form of peritoneal metastasis. Such recurrence may be attributable to possible intraperitoneal dissemination of malignant cells already present at the time of surgery. We performed intraoperative peritoneal cytology on patients with scirrhous carcinoma of the stomach. Free cancer cells were demonstrated in the Douglas cavity in 16 of 32 (50%) patients who underwent potentially curative gastrectomy. The postoperative 5-year survival rate was 23% in patients without detectable free cancer cells in the peritoneal cavity, compared with only 9% in patients with microscopic evidence of intraperitoneal free cancer cells. Therefore, we have applied hyperthermic continuous peritoneal perfusion (CHPP) on patients with scirrhous carcinoma of the stomach in order to develop a surgical adjuvant therapy effective for the prevention of recurrence of peritoneal involvement. The results obtained so far from our study have shown an increased 3-year survival rate of patients undergoing potentially curative gastrectomy, but no improvement of therapeutic outcome in terms of postoperative 5-year survival.
在大约80%的胃硬癌患者中，即使进行了潜在根治性切除，癌症仍会复发，且复发最常表现为腹膜转移。这种复发可能归因于手术时已存在的恶性细胞可能的腹腔内播散。我们对胃硬癌患者进行了术中腹腔细胞学检查。在32例接受潜在根治性胃切除术的患者中，有16例（50%）在Douglas腔发现游离癌细胞。腹腔内未检测到游离癌细胞的患者术后5年生存率为23%，而有腹腔内游离癌细胞微观证据的患者仅为9%。因此，我们对胃硬癌患者应用了热灌注持续腹腔灌注（CHPP），以开发一种对预防腹膜受累复发有效的手术辅助治疗方法。到目前为止，我们的研究结果显示，接受潜在根治性胃切除术的患者3年生存率有所提高，但术后5年生存率方面的治疗效果没有改善。
