Studies on topical chemotherapy of tumor-contaminated surgical wounds

Abstract

Chemotherapeutic compounds for irrigation of potentially tumor-contaminated surgical fields were evaluated in a multiscreen system. Sixty compounds were tested for their ability to produce total tumor inhibition when mixed with Ehrlich-Lettre ascites tumor in vitro prior to intraperitoneal injection in mice. Compounds which passed this screen without causing any systemic toxic effects were tested in rabbit wounds contaminated with V-2 carcinoma. They were also tested for their ability to inhibit dehydrogenases in fresh normal and malignant tissue from individual patients. The most effective compounds were used for irrigation of surgical wounds following excision of extensive cancer of the upper parts of the gastrointestinal and respiratory tracts. Surgical wounds of fifty-six patients were irrigated, thirty-nine with test compounds and seventeen with saline solution as a control. The incidence of tumor recurrence in wounds irrigated with the compounds was compared with that in wounds irrigated with saline solution. Data available, thus far, show that the recurrence rate was higher in wounds irrigated with nitrogen mustard and sodium hypochlorite than in wounds irrigated with saline solution.