Efficacy of Continuous Hyperthermic Peritoneal Perfusion for the Prophylaxis and Treatment of Peritoneal Metastasis of Advanced Gastric Cancer: Evaluation by Multivariate Regression Analysis
Thirty-two patients with advanced gastric cancer underwent continuous hyperthermic peritoneal perfusion (CHPP) combined with surgery: to prevent peritoneal recurrence in 15 patients without peritoneal metastasis (prophylactic CHPP) and to treat 17 patients with peritoneal metastases (therapeutic CHP...
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| Veröffentlicht in: | Oncology 1999-01, Vol.57 (2), p.106-114 |
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| creator | Hirose, Kazuo Katayama, Kanji Iida, Atsushi Yamaguchi, Akio Nakagawara, Gizo Umeda, Syun-ichi Kusaka, Yukinori |
| description | Thirty-two patients with advanced gastric cancer underwent continuous hyperthermic peritoneal perfusion (CHPP) combined with surgery: to prevent peritoneal recurrence in 15 patients without peritoneal metastasis (prophylactic CHPP) and to treat 17 patients with peritoneal metastases (therapeutic CHPP). The postoperative outcome was compared with that of control patients treated with surgery alone. Peritoneal recurrence was less frequent (26%) and the 5-year survival rate was significantly higher (39%) in the patients with prophylactic CHPP than in 40 control patients (42 and 17%, respectively). The patients with therapeutic CHPP showed significantly better median survival than did 20 control patients (11 vs. 6 months). Cox multivariate regression analysis revealed that CHPP was an independent prognostic factor in the prophylactic study (hazard ratio = 0.3965), and that the independent prognostic factor in the therapeutic study was not CHPP but complete resection of the peritoneal metastasis. Thus, CHPP has no marked benefit for established peritoneal metastasis. CHPP for the prevention of peritoneal recurrence may have a beneficial effect on long-term survival, but a prospective randomized trial is needed to clarify its prognostic value. |
| doi_str_mv | 10.1159/000012016 |
| format | Article |
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The postoperative outcome was compared with that of control patients treated with surgery alone. Peritoneal recurrence was less frequent (26%) and the 5-year survival rate was significantly higher (39%) in the patients with prophylactic CHPP than in 40 control patients (42 and 17%, respectively). The patients with therapeutic CHPP showed significantly better median survival than did 20 control patients (11 vs. 6 months). Cox multivariate regression analysis revealed that CHPP was an independent prognostic factor in the prophylactic study (hazard ratio = 0.3965), and that the independent prognostic factor in the therapeutic study was not CHPP but complete resection of the peritoneal metastasis. Thus, CHPP has no marked benefit for established peritoneal metastasis. CHPP for the prevention of peritoneal recurrence may have a beneficial effect on long-term survival, but a prospective randomized trial is needed to clarify its prognostic value.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000012016</identifier><identifier>PMID: 10461056</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject><![CDATA[Adult ; Aged ; Antibiotics, Antineoplastic - administration & dosage ; Antineoplastic Agents, Phytogenic - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Biological and medical sciences ; Chemotherapy, Cancer, Regional Perfusion - instrumentation ; Chemotherapy, Cancer, Regional Perfusion - methods ; Cisplatin - administration & dosage ; Clinical Study ; Etoposide - administration & dosage ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hot Temperature ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitomycin - administration & dosage ; Multivariate Analysis ; Peritoneal Cavity ; Peritoneal Neoplasms - drug therapy ; Peritoneal Neoplasms - prevention & control ; Peritoneal Neoplasms - secondary ; Proportional Hazards Models ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Treatment Outcome ; Tumors]]></subject><ispartof>Oncology, 1999-01, Vol.57 (2), p.106-114</ispartof><rights>1999 S. Karger AG, Basel</rights><rights>1999 INIST-CNRS</rights><rights>Copyright (c) 1999 S. 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The postoperative outcome was compared with that of control patients treated with surgery alone. Peritoneal recurrence was less frequent (26%) and the 5-year survival rate was significantly higher (39%) in the patients with prophylactic CHPP than in 40 control patients (42 and 17%, respectively). The patients with therapeutic CHPP showed significantly better median survival than did 20 control patients (11 vs. 6 months). Cox multivariate regression analysis revealed that CHPP was an independent prognostic factor in the prophylactic study (hazard ratio = 0.3965), and that the independent prognostic factor in the therapeutic study was not CHPP but complete resection of the peritoneal metastasis. Thus, CHPP has no marked benefit for established peritoneal metastasis. 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The postoperative outcome was compared with that of control patients treated with surgery alone. Peritoneal recurrence was less frequent (26%) and the 5-year survival rate was significantly higher (39%) in the patients with prophylactic CHPP than in 40 control patients (42 and 17%, respectively). The patients with therapeutic CHPP showed significantly better median survival than did 20 control patients (11 vs. 6 months). Cox multivariate regression analysis revealed that CHPP was an independent prognostic factor in the prophylactic study (hazard ratio = 0.3965), and that the independent prognostic factor in the therapeutic study was not CHPP but complete resection of the peritoneal metastasis. Thus, CHPP has no marked benefit for established peritoneal metastasis. CHPP for the prevention of peritoneal recurrence may have a beneficial effect on long-term survival, but a prospective randomized trial is needed to clarify its prognostic value.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>10461056</pmid><doi>10.1159/000012016</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Oncology, 1999-01, Vol.57 (2), p.106-114 |
| issn | 0030-2414 1423-0232 |
| language | eng |
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| source | MEDLINE; Karger Journals Complete |
| subjects | Adult Aged Antibiotics, Antineoplastic - administration & dosage Antineoplastic Agents, Phytogenic - administration & dosage Antineoplastic Combined Chemotherapy Protocols - administration & dosage Biological and medical sciences Chemotherapy, Cancer, Regional Perfusion - instrumentation Chemotherapy, Cancer, Regional Perfusion - methods Cisplatin - administration & dosage Clinical Study Etoposide - administration & dosage Female Gastroenterology. Liver. Pancreas. Abdomen Hot Temperature Humans Male Medical sciences Middle Aged Mitomycin - administration & dosage Multivariate Analysis Peritoneal Cavity Peritoneal Neoplasms - drug therapy Peritoneal Neoplasms - prevention & control Peritoneal Neoplasms - secondary Proportional Hazards Models Stomach Neoplasms - drug therapy Stomach Neoplasms - pathology Stomach Neoplasms - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Treatment Outcome Tumors |
| title | Efficacy of Continuous Hyperthermic Peritoneal Perfusion for the Prophylaxis and Treatment of Peritoneal Metastasis of Advanced Gastric Cancer: Evaluation by Multivariate Regression Analysis |
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