Kobayashi K, Fujimoto S, Takahashi M, Muto T, Toyosawa T
Dept. of Surgery, Social Insurance Funabashi Central Hospital.
Gan To Kagaku Ryoho. 1998 Jul;25(9):1436-8.
In order to evaluate clinical effects of intraperitoneal hyperthermic chemoperfusion (IHCP) to prevent peritoneal recurrence in gastric cancer patients with serosal invasion, the clinical outcome was studied in 126 gastric cancer patients with macroscopic serosal invasion. Results of 59 patients who had surgery combined with IHCP (IHCP group) were compared with those of 67 patients who had surgery alone (control group). IHCP was performed for 120 minutes just after surgery under hypothermic general anesthesia with perfusate containing 10 micrograms/ml of mitomycin C. The inflow temperature and the outflow temperature of the perfusate were controlled to be 44.5 approximately 45 degrees C, and 43 approximately 44 degrees C, respectively. The 2-, 4- and 8-year survival rates for the IHCP group were 86%, 74% and 66%, respectively, against 78%, 59% and 50%, respectively, in the control group. The survival rates of the IHCP group were significantly better than those of the control group. Peritoneal recurrences after surgery were encountered in one of 59 patients in the IHCP group and 17 of 67 patients in the control group. The peritoneal recurrence rate of the IHCP group was significantly lower than that of the control group. These results suggest that IHCP treatment is effective in prevention of peritoneal recurrences after surgery for gastric cancer patients with serosal invasion.
为评估腹腔内热灌注化疗（IHCP）预防浆膜侵犯的胃癌患者腹膜复发的临床效果，对126例有肉眼可见浆膜侵犯的胃癌患者的临床结局进行了研究。将59例行手术联合IHCP的患者（IHCP组）与67例单纯行手术的患者（对照组）的结果进行比较。在低温全身麻醉下，于术后即刻用含10微克/毫升丝裂霉素C的灌注液进行120分钟的IHCP。灌注液的流入温度和流出温度分别控制在约44.5至45摄氏度和约43至44摄氏度。IHCP组的2年、4年和8年生存率分别为86%、74%和66%，而对照组分别为78%、59%和50%。IHCP组的生存率明显优于对照组。IHCP组59例患者中有1例出现术后腹膜复发，对照组67例患者中有17例出现术后腹膜复发。IHCP组的腹膜复发率明显低于对照组。这些结果表明，IHCP治疗对预防浆膜侵犯的胃癌患者术后腹膜复发有效。
