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Early Postoperative Intraperitoneal Chemotherapy with Mitomycin C, 5-Fluorouracil and Cisplatin for Advanced Gastric Cancer

 Noh S.H.  ;  Yoo C.H.  ;  Chung H.C.  ;  Roh J.K.  ;  Shin D.W.  ;  Min J.S. 
 ONCOLOGY, Vol.60(1) : 24-30, 2001 
Journal Title
Issue Date
Adult ; Antibiotics, Antineoplastic/administration & dosage ; Antimetabolites, Antineoplastic/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemotherapy, Adjuvant ; Cisplatin/administration & dosage ; Feasibility Studies ; Female ; Fluorouracil/administration & dosage ; Gastrectomy* ; Humans ; Infusions, Parenteral ; Lymphatic Metastasis ; Male ; Middle Aged ; Mitomycin/administration & dosage ; Neoplasm Invasiveness ; Neoplasm Staging ; Peritoneal Neoplasms/prevention & control* ; Peritoneal Neoplasms/secondary ; Proportional Hazards Models ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery ; Survival Analysis ; Time Factors ; Treatment Failure ; Treatment Outcome
Intraperitoneal chemotherapy ; Gastric cancer ; Prognosis
The long-term survival of patients who undergo surgery for stage IV gastric cancer is poor, due to metastatic spread of the tumor. Intraperitoneal chemotherapy (IPT) as a possible treatment for peritoneal dissemination has been investigated in a number of different tumors. The aim of this study was to investigate the toxicity and impact of early postoperative IPT on the survival of patients with advanced gastric cancer.
Between 1993 and 1997, a total of 91 patients with stage IV gastric cancer who underwent potentially curative or palliative resection received intraperitoneal mitomycin C before closure of the abdominal wound. 5-Fluorouracil and cisplatin were administered intraperitoneally on postoperative days 1-4, and this was repeated at 4-week intervals.
All patients received a median of 3 IPT perfusions. There were 24 (26.4%) postoperative complications and 1 (1.1%) mortality. The most frequent hematologic toxicity (grade 3-4) was leukopenia. The major nonhematologic toxicities (grade 3-4) were emesis and nephrotoxicity. After a median follow-up period of 26 months, 14 patients remain alive without evidence of recurrence, whereas 75 patients died due to recurrence or progression of disease. The median survival period for all 91 patients was 15.4 months. When survival according to the residual tumor was analyzed, median survival was 36.0 months in the R0 (curative resection) group, 20.6 months in the R1 group (margins of resected specimens showing microscopic residual tumor or diameter of each residual tumor less than 3 mm) and 9.0 months in the R2 group (macroscopic residual tumor larger than 3 mm) (p < 0.001).
IPT was found to be safe, and it appears to improve the prognosis in patients with minimal residual tumors. However, complete cytoreductive surgery is mandatory for achieving the beneficial effect of IPT.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Roh, Jae Kyung(노재경)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
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