Gastric Cancer

, Volume 5, Issue 3, pp 0168–0172 | Cite as

Extensive intraoperative peritoneal lavage and chemotherapy for gastric cancer patients with peritoneal free cancer cells

  • Shinya Shimada
  • Eiji Tanaka
  • Takashi Marutsuka
  • Ubehiko Honmyo
  • Hidehiro Tokunaga
  • Yasushi Yagi
  • Norimitsu Aoki
  • Michio Ogawa
Short communication

Abstract.

The effects of extensive intraoperative peritoneal lavage (EIPL) for gastric cancer patients with peritoneal free cancer cells were investigated. This study was based on 22 consecutive patients with peritoneal free cancer cells, among 663 patients who underwent curative surgical treatment for advanced gastric cancer. The 22 patients were followed up for 2 years or until death. These patients were divided into three groups: group 1, patients with no additional intraoperative therapy (from 1989 to 1992; n = 8); group 2, patients with intraoperative intraperitoneal chemotherapy alone (from 1992 to 1995; n = 7); and group 3, patients with EIPL followed by intraoperative intraperitoneal chemotherapy (from 1996 to 1999; n = 7). Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed that viable cancer cells were not detected after the eighth EIPL in a gastric cancer patient with numerous intraperitoneal free cancer cells. In group 3, 4 of the 7 patients survived for more than 2 years, including 3 with cancer-free status, whereas no patient survived cancer-free in groups 1 and 2. The peritoneal recurrence rates and cancer-specific 2-year survival rates in groups 1, 2, and 3 were 100%, 85.7% and 42.9%; and 0%, 14.3%, and 57.1%, respectively. The 2-year survival rate of group 3 was significantly higher than that of group 1 (P = 0.017) and that of group 2 (P = 0.025). In a subset analysis, patients with peritoneal free gastric cancer cells but no macroscopic dissemination showed a statistically significant improvement in survival those treated with EIPL compared with those not treated with EIPL.

Key words Gastric carcinoma Peritoneal free cancer cells Dissemination Peritoneal lavage Chemotherapy 

Copyright information

© International and Japanese Gastric Cancer Associations 2002

Authors and Affiliations

  • Shinya Shimada
    • 1
  • Eiji Tanaka
    • 2
  • Takashi Marutsuka
    • 2
  • Ubehiko Honmyo
    • 2
  • Hidehiro Tokunaga
    • 3
  • Yasushi Yagi
    • 4
  • Norimitsu Aoki
    • 1
  • Michio Ogawa
    • 2
  1. 1. Department of Surgery, Yatsushiro Health Insurance General Hospital, Kumamoto 866-8660, JapanJP
  2. 2. Second Department of Surgery, Kumamoto University School of Medicine, Kumamoto, JapanJP
  3. 3. Department of Surgical Pathology, Kumamoto University School of Medicine, Kumamoto, JapanJP
  4. 4. Department of Surgery, Kumamoto Regional Hospital, Kumamoto, JapanJP

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