Efficacy of Intraoperative Hyperthermic Peritoneal Perfusion on 60 Patients with Advanced Gastric Carcinoma / 中国肿瘤临床

ABSTRACT

Objective: To evaluate the efficacy of intraoperative hyperthermic peritoneal perfusion (CHPP) on advanced gastric carcinoma. Methods: Sixty patients with advanced gastric carcinoma were divided into the control group and the treatment group. All patients underwent radical gastrectomy and D2 node dissection. Patients in the treatment group received CHPP when surgical resection was completed. Patients in the control group underwent resection of gastric carcinoma without CHPP. Chemotherapy was administered with FOLFOX4 regimen intravenously for 12 cycles in both groups at 4 weeks after surgery. The serum Carcinoembryonic antigen (CEA) and CA19-9 were measured in patients with advanced gastric cancer before and after resection of tumor. Survival and recurrence in both groups were analyzed and compared. Results: The mean levels of the expression of CEA and CA19-9 in the peripheral blood of the 60 patients were significantly higher than the upper limits of normal (55.89±22.25μg/L vs 0～5μg/L; 125.35±61.78 U/mL vs 0～39U/mL P< 0.01). There were no significant differences in the mean levels of the expression of CEA and CA19-9 in the peripheral blood between the treatment group and the control group (54.67±22.95μg/L vs 56.09±22.15μg/L; 126.16±62.45 U/mL vs 123.35±60.88 U/mL,P>0.05). The serum CEA and CA19-9 levels were significantly decreased at 7 days after treatment in the treatment group (7.58±3.21 μg/L, 31.35±13.47 U/mL, P<0.01). The levels of these two tumor markers were decreased unremarkably at 7 days after treatment in the control group (37. 68±20.59μg/L, 98.23±36.28 U/mL, P>0.05). The serum CEA and CA19-9 levels were decreased significantly in both groups at 30 days after surgery (P<0.05). One-year survival and recurrence rates were 83.3% and 10% in the treatment group and 80% and 13.3% in the control group, with no significant differences between the two groups (P>0.05). Three-year survival and recurrence rates were 63.3% and 20% in the treatment group and 40% and 40% in the control group, with a significant difference between the two groups (P<0.05). Conclusion: Surgical resection combined with CHPP can significantly decrease the serum CEA and CA19-9 levels. Intraoperative CHPP for patients with advanced gastric carcinoma is helpful for preventing peritoneal metastasis and recurrence and can prolong survival time.