Viability of intraperitoneal free cancer cells in patients with gastric cancer.

The viability and morphologic changes of intraperitoneal free cancer cells in advanced gastric cancer patients were examined by Giemsa and enzymologic staining and by tritiated thymidine uptake. Although many free cancer cells in the pouch of Douglas showed moderate degeneration, viable, morphologically intact cells were noted, leading to the possibility of their implantation and proliferation in the peritoneum. Serosal cancer cells showed a high degree of viability. In patients undergoing gastric cancer surgery, the viability of free cancer cells was markedly decreased by a single intraoperative administration of 10 mg of mitomycin C (MMC) to the pouch of Douglas, suggesting that this may represent an effective means of preventing peritoneal dissemination.