Kaibara N
First Department of Surgery, Tottori University, Yonago, Japan.
Nihon Geka Gakkai Zasshi. 1996 Apr;97(4):308-11.
Between 1976 and 1984, 234 patients with advanced gastric cancer (pT3, pT4) were curatively gastrectomized and intraperitoneal free cancer cells which were detected by lavave of the Douglas cavity were recognized in 17.8% of the patients with pT3 and 25.0% of those with pT4. Even if curative surgery was performed for patients with free cancer cells, their five-year survival rate was very poor. The five-year survival rate was very poor. The five-year survival of patients with curatively operated gastric cancer without free cancer cells was 49.3%, whereas that of patients with free cancer cells was significantly lower (15.4%). Then the results of treatment for patients with free cancer cells were analyzed in regard to the effect of continuous hyperthermic peritoneal perfusion (CHPP) as prophylaxis of peritoneal metastasis. Five-year survival rate in the patients treated with CHPP was 33.3% and it was only 4.2% in the controls. In patients without intraperitoneal free cancer cells, however, no difference was observed in the five-year survival rates between those patients who had been treated with CHPP and the controls. Therefore, it is reasonable to assume that CHPP can be effective in preventing peritoneal recurrence of resected gastric cancer that is positive for free cancer cells in the peritoneal cavity and peritoneal micrometastasis.
1976年至1984年间，234例晚期胃癌（pT3、pT4）患者接受了根治性胃切除术，Douglas腔灌洗检测出腹腔游离癌细胞的患者在pT3患者中占17.8%，在pT4患者中占25.0%。即使对有游离癌细胞的患者进行了根治性手术，他们的五年生存率也非常低。五年生存率非常低。无游离癌细胞的根治性手术胃癌患者的五年生存率为49.3%，而有游离癌细胞的患者的五年生存率则显著较低（15.4%）。然后分析了有游离癌细胞患者的治疗结果，以探讨持续高温腹腔灌注（CHPP）预防腹腔转移的效果。接受CHPP治疗的患者的五年生存率为33.3%，而对照组仅为4.2%。然而，在无腹腔游离癌细胞的患者中，接受CHPP治疗的患者与对照组的五年生存率没有差异。因此，可以合理地假设，CHPP对于预防腹腔游离癌细胞阳性的切除胃癌的腹腔复发和腹腔微转移可能是有效的。
