Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. bskim@www.amc.seoul.kr
ABSTRACT
PURPOSE: We performed retrospective study to evaluate the preventive effect of intraperitoneal cisplatin installation (IPCI) on peritoneal recurrence after curative resection of advanced gastric cancer.
MATERIALS AND METHODS: The effect of IPCI was evaluated in 297 advanced gastric carcinoma patients from January 1993 to December 1996. In IPCI group, 100 mg/body of cisplatin in one liter of saline was installed in peritoneal cavity before wound closure in operating room and drained out 2 hours later. Postoperative adjuvant chemotherapy with combination of 5-FU and cisplain was performed. 155 cases were treated by IPCI.
Median follow-up period was 26 months.
RESULTS: Out of 139 (46.8%) recurred cases, peritoneal, local and distant recurrences developed in 65 (37.8%) cases, 66 (38.4%) cases and 41 (23.8%) cases respectively. In univariated analysis for survival and recurrence, IPCI, T stage and N stage were significant prognostic factors. As regards to peritoneal recurrence, IPCI and T stage were significant factors. In multivariated survival analysis, as regards to recurrence, IPCI, T stage and N stage were significant prognostic factors. As regards to peritoneal recurrence, IPCI was the only significant independent prognostic factor.
CONCLUSION: We concluded that IPCI can effectively prevent peritoneal recurrence and overall recurrence and it shows marginal survival benefit in advanced gastric cancer patients with serosa invasion.
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