Ikeguchi M, Kondou A, Oka A, Tsujitani S, Maeta M, Kaibara N
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
Eur J Surg. 1995 Aug;161(8):581-6.
To evaluate the effects of continuous hyperthermic peritoneal perfusion (CHPP) together with standard chemotherapy on the prognosis of patients with gastric cancer invading the serosa.
Retrospective study.
University hospital, Japan.
174 patients who had undergone curative resection for gastric cancer invading the serosa (T3) between 1980 and 1989, 78 of whom had been randomised to be treated with CHPP after operation and 96 who received standard chemotherapy.
CHPP was done immediately after operation; 8-10 l fluid containing 80-100 mg/m2 mitomycin C was perfused at a rate of 100-200 ml/minute, and inflow and out flow temperatures were maintained at 44-45 degrees C and 40-42 degrees C, respectively. This was followed by a standard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil (1:4) (UFT). The control group received the standard regimen only.
Five year survival and patterns of recurrence in three groups: no lymph node metastases, 1-9, and 10 or more.
Only in the group with 1-9 lymph node metastases was there an appreciable but not significant difference in 5 year survival: 66% compared with 44% (p = 0.084). The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls.
CHPP improved prognosis in patients with T3 gastric cancer who had only 1-9 metastatic lymph nodes.
评估持续高温腹腔灌注（CHPP）联合标准化疗对侵犯浆膜层胃癌患者预后的影响。
回顾性研究。
日本大学医院。
1980年至1989年间因侵犯浆膜层（T3）胃癌接受根治性切除术的174例患者，其中78例术后随机接受CHPP治疗，96例接受标准化疗。
术后立即进行CHPP；以100 - 200毫升/分钟的速度灌注含80 - 100毫克/平方米丝裂霉素C的8 - 10升液体，流入和流出温度分别维持在44 - 45摄氏度和40 - 42摄氏度。随后采用丝裂霉素C与1-(2-四氢呋喃基)-5-氟尿嘧啶/尿嘧啶（1:4）（UFT）的标准方案。对照组仅接受标准方案。
三组患者的五年生存率及复发模式：无淋巴结转移、1 - 9个淋巴结转移、10个或更多淋巴结转移。
仅在有1 - 9个淋巴结转移的组中，五年生存率存在明显但无显著差异：分别为66%和44%（p = 0.084）。CHPP组腹膜转移患者的平均无病生存期为30个月，而对照组为23个月。
CHPP改善了仅有1 - 9个转移淋巴结的T3期胃癌患者的预后。
