Effect Of Intraperitoneal Chemotherapy Research Articles

Targeting Adhesive Tumor Adventitia via Injectable Electrospun Short Fibers in Perfusion of Intraperitoneal Sporadic Tumors.

Intraperitoneal sporadic tumor is a common and complicated syndrome in cancers, causing a high rate of death, and people find that intraperitoneal chemotherapy (IPC) can treat intraperitoneal sporadic tumors better than intravenous chemotherapy and surgery. However, the effectiveness and side effects of IPC are controversial, and the operation process of IPC is complicated. Herein, the injectable paclitaxel-loaded (PTX-loaded) electrospun short fibers are constructed through a series process of electrospinning, homogenizing, crosslinking, and subsequent polydopamine coating and folate acid (FA) modification. The evenly dispersed short fibers exhibited effective tumor cell killing and good injectable ability, which is convenient to use and greatly improved the complex operation procedure. Mussel-like protein poly-dopamine coating and FA modification endowed short fibers with the ability of targeted adhesion to tumors, and therefore the short fibers further acted as a kind of micro membrane that could release drugs to tumors at close range, maintaining local high drug concentration and prevent paclitaxel killing normal tissues. Thus, the target-adhesive injectable electrospun short fibers are expected to be the potential candidate for cancer treatment, especially the intraperitoneal sporadic tumors, which are hard to treat by surgery or intravenous chemotherapy.

Cytoreductive Surgery and Intraperitoneal Chemotherapy in Advanced Serous Epithelial Ovarian Cancer: A 14-Year French Retrospective Single-Center Study of 124 Patients.

Ovarian cancer (OC) is the most lethal gynecological cancer. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy appears to increase survival, and normothermic intraperitoneal chemotherapy (IPC) could improve overall survival (OS). Furthermore, intraperitoneal epinephrine could decrease the toxicity of chemotherapy by decreasing the systemic absorption of chemotherapy. The goal of this study was to assess the effects of CRS and IPC with intraperitoneal epinephrine, as first-line therapy, on the survival of patients with serous epithelial OC (EOC) with peritoneal metastases. A prospective monocentric database was retrospectively searched for all patients with advanced serous EOC treated by interval or consolidative CRS plus IPC with intraperitoneal epinephrine after neoadjuvant chemotherapy. OS and disease-free survival (DFS), postoperative complications, and prognostic factors were analyzed. From January 2003 to December 2017, 124 patients with serous EOC were treated with interval (n = 58) or consolidative (n = 66) complete CRS plus IPC with intraperitoneal epinephrine. The median follow-up was 77.8 months, the median OS was 60.8 months, and the median DFS was 21.2 months. In our multivariate analysis, a higher Peritoneal Cancer Index (PCI) and positive lymph node status resulted in worse OS, while higher World Health Organization score, higher PCI score, and positive lymph node status were risk factors for worse DFS. Grade 3 or higher surgical morbidity occurred in 27.42% of cases; only 3.2% had grade 3 renal toxicity and mortality was 0.8%. CRS and IPC with intraperitoneal epinephrine in stage III EOC offer good OS and DFS with acceptable morbidity and mortality rates.

Treatment of advanced-stage ovarian cancer including combination of intra-abdominal chemotherapy

Introduction.Ovarian cancer is the leading cause of death from gynecological malignancies: the one-year relative survival rate with stages 3 and 4 of the disease is 20%. The results of treatment remain unsatisfactory, which dictates the need to find new methods of treatment. The aim of the study was to evaluate the effectiveness of the use of HIIH (hyperthermic intraperitoneal intraoperative chemoperfusion, HIPEC) in patients with the diagnosis of: ovarian cancer IIIA-From the stage of the disease.Materials and methods.117 cases of stage IIIA-C ovarian cancer treated at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from January 2014 to March 2021 were retrospectively studied. All patients underwent 3 cycles of neoadjuvant chemotherapy (NAPHT) according to the paclitaxel+carboplatin (PCb) scheme, followed by surgical treatment to the extent of maximum cytoreductive surgery. Two study groups were formed: 1 — cases with GIIH (N=57), 2-without GIIH (N=60). On the 14-16 day after the operation, all patients underwent 3 cycles of adjuvant chemotherapy according to the PCb scheme.Results.A significant increase in overall survival was found in the first group of patients with HIPEC. This technique allows to increase the survival rate of patients for 14 months at stage IIIA-B (p<0.05). At stage IIIC, there was no statistically significant difference in the survival rate of patients. There was a tendency to increase the survival rate by 5 months (p>0.05), which is associated with the pronounced prevalence of the tumor process and the technical impossibility of removing the tumor. Discussion.The concentration of drugs in the abdominal cavity and in the blood plasma significantly differs due to the functioning of the peritoneal-plasma barrier, which leads to a lower toxicity in comparison with systemic chemotherapy, and therefore allows you to give a large dose of the drug with fewer adverse events, and the fact of hyperthermia (42°C) has a positive effect on the effectiveness of intraperitoneal chemotherapy. To date, this method has not been included in the clinical recommendations on the territory of the Russian Federation, but data from foreign literature, including randomized trials, have shown the high effectiveness of this method.Conclusion.The results obtained in the course of our study demonstrate the effectiveness of this technique, in the form of an increase in overall and relapse-free survival with acceptable toxicity.

The effect of intraperitoneal chemotherapy after interval cytoreductive surgery on recurrence and survival in patients with advanced-stage ovarian carcinoma

Objective: The aim of this study was to compare recurrence-free survival (RFS) and overall survival (OS) in patients with stage III–IV ovarian cancer who received intraperitoneal (IP) chemotherapy after neoadjuvant intravenous (IV) chemotherapy and interval cytoreductive surgery.

Preparing the peritoneal surface for intraperitoneal chemotherapy using high-intensity ultrasound (HIUS): Investigation of technical feasibility, safety and possible limitations.

e16045 Background: The penetration of chemotherapeutic drugs into metastatic peritoneal nodules remains at levels well below 1 mm, thus significantly limiting the antitumor effect of intraperitoneal chemotherapy (IPC). Recently, high-Intensity ultrasound (HIUS) has been discovered as a potential tool to improve peritoneal diffusion rates. Despite promising preliminary data, basic aspects regarding its technical feasibility, safety and possible limitations remain unclear. This study aims to enhance our current understanding of HIUS and test its applicability using an ex-vivo swine model. Methods: Three postmortem swine were subject to laparotomy with consecutive lavage with 0.9%NaCl saline and HIUS application. For this purpose, a large HIUS radiating pen was introduced into the abdominal cavity and HIUS was applied on two of the four abdominal quadrants for 300 seconds each at an output power of 70 W, 50 % amplitude and 20 kHz frequency. Following the procedure, small intestinal tissue samples were removed for further analyses. Results: In all specimen, peritoneal and subperitoneal layers showed structural changes only visible on a microscopic level. The peritoneal layer was transformed into a mash-like structure while the subperitoneal layer (depth of 142 +/- 28 µm) exhibited microcavities and vascular detachment from surrounding tissues. No bowel rupture or vascular perforations were observed. Conclusions: Our data indicate that HIUS is a technically feasible add-on procedure for IPC with measurable microscopic changes on the peritoneal surface and no apparent bowel toxicity. Pretreatment of the abdominal cavity with HIUS could significantly improve IPC efficacy. Further studies are required to optimize and evaluate this novel approach.

Successful treatment of peritoneal recurrence after gastric cancer surgery with intravenous and intraperitoneal paclitaxel combined with S-1 chemotherapy: a case report

BackgroundDespite recent advances in systemic chemotherapy, the prognosis of patients with peritoneal metastases from gastric cancer still remains poor. Nonetheless, several efficacious intraperitoneal chemotherapy regimens have recently been developed for patients with peritoneal metastases. However, no study has investigated the effectiveness of intraperitoneal chemotherapy for metachronous peritoneal metastases from gastric cancer after curative surgery.Case presentationWe herein report a case of a 65-year-old man who had metachronous peritoneal metastases from gastric cancer after curative total gastrectomy who had been successfully treated with intraperitoneal chemotherapy. One month after surgery, adjuvant chemotherapy with S-1 was initiated given a final pathological stage of IIIB (pT4aN2M0). However, during adjuvant chemotherapy 12 months after surgery, tumor marker levels, which had been within normal range before surgery, increased with abdominal contrast-enhanced computed tomography (CT) revealing pelvic ascites. Thereafter, staging laparoscopy was performed, and the patient was diagnosed with peritoneal recurrence of gastric cancer. Following staging laparoscopy, an intraperitoneal access port was subcutaneously implanted for subsequent intraperitoneal chemotherapy. Combined chemotherapy with intraperitoneal and intravenous administration of paclitaxel and oral S-1 was then provided. After one course of combined chemotherapy, peritoneal lavage cytology was negative for malignancy. CT showed gradually decreasing ascites, whereas tumor marker levels returned to normal. The patient continued chemotherapy without major side effects and remained progression-free for 33 months with 36 chemotherapy cycles.ConclusionsA combination regimen including intraperitoneal chemotherapy could be a promising option for patients with peritoneal recurrence after gastric cancer surgery.

Efficacy and safety of intraperitoneal chemotherapy in patients with advanced gastric cancer: a cumulative meta-analysis of randomized controlled trials.

Even when a curative gastrectomy is conducted, the majority of advanced gastric cancer patients with invasion die due to peritoneal recurrence. We performed electronic searches to identify randomized controlled trials published through April 2017 evaluating the effect of intraperitoneal chemotherapy (IPC) on survival rates. We included 23 trials reporting data on 2,767 patients with advanced gastric cancer. Overall, we noted that patients who received IPC had a significantly increased 1-year survival rate, and the treatment effect of IPC on 1-year survival was most prominent in studies conducted in Japan or those with a mean age of less than 60 years. IPC was also associated with an increased incidence of 2-year survival rate, but it was not seen to have this effect in studies conducted in China or Australia or with a mean age greater than 60 years. Similarly, IPC associated with a significantly increased 3-year survival rate, but this difference was not detected in studies conducted in Austria or with a mean age greater than 60 years. IPC has no significant effect on the 5-year survival rate. Finally, IPC was associated with a lower risk of recurrence in patients with advanced gastric cancer. The findings of this study suggest that gastric cancer patients who receive IPC associate with increased 1-year, 2-year, and 3-year survival rates, but this does not extend out to a 5-year survival rate. IPC is also shown to play a protective role against the risk of recurrence in patients with advanced gastric cancer.

Surgical treatment of scirrhous gastric carcinoma

Scirrhous gastric carcinoma is a special type of gastric carcinomas and accompanied with highly interstitial fibrosis and diffuse cellular infiltration. Scirrhous gastric carcinoma is mainly composed of poor-differentiated adenocarcinoma and signet-ring cell carcinoma, with the clinical features of Borramann 4, thickening and stenosis of stomach wall, high peritoneal and lymph node metastases rates and poor prognosis. R0 resection and postoperative chemotherapy with S-1 as a main way are necessary for the patients who are able to undergo curable resection. The palliative operation should be applied to patients with ileus and urinary obstructions caused by peritoneal metastasis because of limited effect of surgical treatment. Chemo-therapy is the best choice for patients who are not able to undergo curable resection, conversional therapy can improve the prognosis of patients, and preoperative S-1/CDDP combination chemotherapy is an expectable therapy. Moreover, controlling peritoneal metastasis and effect of intraperitoneal chemotherapy are much anticipated. The efficiency of molecular targeted therapy by bevacizumab and gene therapy by adenovirus remain further study. Key words: Gastric neoplasms, scirrhous; Surgical procedures, operative; Chemotherapy

Inhibitory effect of intraperitoneal chemotherapy with sustained-release fluorouracil vs fluorouracil injection on peritoneally transplanted MKN-45 tumors in nude mice

Inhibitory effect of intraperitoneal chemotherapy with sustained-release fluorouracil <i>vs</i> fluorouracil injection on peritoneally transplanted MKN-45 tumors in nude mice

Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer

PurposeA 2006 randomized trial demonstrated a 16-month survival benefit with intraperitoneal and intravenous (IP/IV) chemotherapy administered to patients who had ovarian cancer, compared with IV chemotherapy alone, but more treatment-related toxicities. The objective of this study was to examine the use and effectiveness of IP/IV chemotherapy in clinical practice.Patients and MethodsProspective cohort study of 823 women with stage III, optimally cytoreduced ovarian cancer diagnosed at six National Comprehensive Cancer Network institutions. We examined IP/IV chemotherapy use in all patients diagnosed between 2003 and 2012 (N = 823), and overall survival and treatment-related toxicities with Cox regression and logistic regression, respectively, in a propensity score–matched sample (n = 402) of patients diagnosed from 2006 to 2012, excluding trial participants, to minimize selection bias.ResultsUse of IP/IV chemotherapy increased from 0% to 33% between 2003 and 2006, increased to 50% from 2007 to 2008, and ...

Results of treatment of patients with local recurrence of colon cancer.

Aim : to improve the results of treatment of patients with local recurrence of colon cancer and evaluate effectiveness of the combined treatment. Materials and methods . From 1997 to 2012 in SRCC 71 consecutive patients underwent combined surgery for local recurrence of colon cancer. Of these patients 38 (53.5%) had surgical treatment with intraoperative intraperitoneal chemotherapy. Sixty-five (91.5%) patients had locally advanced recurrent tumor. Localization of local recurrence in patients who underwent combined operations, was as follows: in the area of colonic anastomosis - in 11 (15.5%) patients; in the bed of the removed tumor - in 19 (26.8%); in the area of colostomy - in 10 cases (14.1%); in the stump of distal colon after obstructive procedures - in 31 (43.6%) patients. Mean operative time was 270 ± 45 minutes and mean blood loss - 430 ± 80 ml. Results . Postoperative complications were observed in 6 (9.8%) of 61 patients. There was no mortality. Sixty-four (90.1%) patients were followed-up, 34 (53.1%) patients of which are currently alive with no signs of the relapse of the disease. Effectiveness of intraperitoneal chemotherapy was evaluated. Repeated local recurrence occurred in 5 (14.3%) of the 35 followed-up patients who underwent intraperitoneal chemotherapy, and in 6 (20.7%) of the 29 followed-up patients who received surgery alone (p = 0.2). Distant metastases were found in 9 (25.7%) and in 5 patients (17.2%) patients, respectively (p = 0.17), and peritoneal carcinomatosis in 1 (2.9%) and 4 (13.8%) cases, respectively (p = 0.09). Disease-free 5-year survival rate in patients who received intraperitoneal chemotherapy was 57.1%, and in patients received only surgical treatment - 48.3% (p = 0.15).

Effect of intraperitoneal chemotherapy on survival for ovarian cancer in clinical practice and frequency of use.

5576 Background: In 2006 the National Cancer Institute (NCI) issued a rare clinical alert recommending intraperitoneal chemotherapy (IP) to treat ovarian cancer after GOG-172, a randomized clinical trial comparing IP and intravenous chemotherapy (IV), demonstrated a 16-month survival advantage with IP. The aims of this study were to determine: (1) changes in IP utilization over time, (2) factors associated with adoption of IP therapy, and (3) the impact of IP on survival. Methods: Prospective cohort study of women with stage III, optimally-cytoreduced ovarian cancer treated at National Comprehensive Cancer Network (NCCN) institutions. Trends were evaluated in 823 patients between 2003-2012. In 603 patients, diagnosed after 2006, multivariable logistic regression and propensity-score analyses were used to examine factors associated with receipt of IP therapy and associations between treatment modality, adverse events, and overall survival. Results: IP utilization rose from 0% to 33% between 2003-2006, increased to 50% in 2007-2008, and decreased to 43% during 2009-2012. At treatment initiation 43% of patients received modified IP regimens, 29% received the GOG 172 regimen, and 28% received IP on a clinical trial. In adjusted analyses, younger age, fewer comorbid conditions, and clinical trial enrollment were associated with IP therapy (all P≤0.01). NCCN center was independently associated with receipt of IP; the adjusted proportion of patients receiving IP varied by site between 16% and 71% (P<0.001). After propensity-score weighted adjustment, patients receiving IP were more likely to switch to IV due to toxicity (AOR=2.01, 95% CI=1.30-3.12) compared with IV. Adjusted 5-year overall survival rates were 57% for IP vs. 44% for IV (hazard ratio=0.69, 95% CI=0.50-0.94). Conclusions: The use of IP therapy increased significantly over the past decade at NCCN centers. However, recently only a minority of eligible patients have received it. Despite frequent modifications, IP chemotherapy is associated with significantly improved survival in clinical practice. Future studies should examine whether site-specific variations in IP utilization reflect patients’ informed treatment preferences.

Intraperitoneal chemotherapy in advanced gastric cancer. Meta-analysis of randomized trials

An important component of treatment failure in gastric cancer (GC) is cancer dissemination within the peritoneal cavity and nodal metastasis. Intraperitoneal chemotherapy (IPC) is considered to give a fundamental contribute in treating advanced GC. The purpose of the study is to investigate the effects of IPC in patients with advanced GC. A systematic review with meta-analysis of randomized controlled trials (RCTs) of IPC + surgery vs. control in patients with advanced GC was performed. Twenty prospective RCTs have been included (2145 patients: 1152 into surgery + IPC arm and 993 into control arm). Surgery + IPC improves: 1, 2 and 3-year mortality (OR = 0.31, 0.27, 0.29 respectively), 2 and 3-year mortality in patients with loco-regional nodal metastasis (OR = 0.28, 0.16 respectively), 1 and 2-year mortality rate in patients with serosal infiltration (OR = 0.33, 0.27 respectively). Morbidity rate was increased by surgery + IPC (OR = 1.82). The overall recurrence and the peritoneal recurrence rates were improved by surgery + IPC (OR = 0.46 and 0.47 respectively). There was no statistically significant difference in lymph-nodal recurrence rate. The rate of haematogenous metastasis was improved by surgery + IPC (OR = 0.63). 1, 2 and 3-year overall survival is incremented by the IPC. No differences have been found at 5-year in overall survival rate. 2 and 3-year mortality rates in patients with nodal invasion and 1 and 2-year mortality rates in patients with serosal infiltration are improved by the use of IPC. IPC has positive effect on peritoneal recurrence and distant metastasis. Morbidity rate is incremented by IPC. Loco-regional lymph-nodes invasion in patients affected by advanced gastric cancer is not a contraindication to IPC.

Flow cytometric quantification of intraperitoneal free tumor cells in patients with peritoneal metastasis

Peritoneal metastasis (PM) is the most life-threatening type of metastasis in abdominal malignancy. To improve the diagnostic accuracy of cytologic detection (CY) of free tumor cells (FTC) in the peritoneal cavity, we tried to quantify the FTC to leukocyte ratio using flow cytometry in patients with peritoneal metastasis. Cells were recovered from ascites or peritoneal lavages from 106 patients who underwent abdominal surgery and additional 89 samples which were obtained from peritoneal catheter or access port in patients with PM (+) gastric cancer. The cells were immunostained with monoclonal antibodies to CD45 and to CD326 (EpCAM). Using flow cytometry, CD326 (+) and CD45 (+) cells were classified as either tumor cells (T) or leukocytes (L) and the T/L ratio (TLR) was calculated. In 106 samples obtained by laparotomy, Median (M) of the TLR of PM (+) patients was 1.39% (0-807.87%) which was significantly higher than PM (-) patients (M=0%, 0-2.14%, P < 0.001). In PM (+) patients, 86 CY (+) samples showed higher TLR than 61 CY (-) samples (M=2.81%, 0.02-1868.44% vs. M=0%, 0-3.45%, p<0.0001). In all of the 24 patients who were monitored for TLR before and after intraperitoneal (IP) chemotherapy, the TLR was reduced which was more dramatic than the results of the change in cytology. TLR measured with FACS is an excellent reflection of the tumor spread in the peritoneal cavity and could be a reliable diagnostic biomarker to determine the severity of PM as well as effectiveness of IP chemotherapy.

Intraperitoneal chemotherapy in advanced gastric cancer. Meta-analysis of randomized trials

Gastric cancer (GC) is the second leading cause of cancer death and the fourth most common cancer in the world. GC disseminates principally through the haematic torrent or through the peritoneal cavity fluids. An important component of treatment failure is cancer dissemination within the peritoneal cavity and nodal metastasis. Intraperitoneal chemotherapy (IPC) gave a fundamental contribute in treating advanced GC. The purpose of the study is to investigate the effects of IPC in patients with advanced GC

The effectiveness of intraperitoneal chemotherapy in treating retroperitoneal stage IIIC ovarian carcinoma

The effectiveness of intraperitoneal chemotherapy in treating retroperitoneal stage IIIC ovarian carcinoma

Quantitative detection of intraabdominal floating tumor cells and clusters using flowcytometry in patients with peritoneal carcinomatosis.

e15027 Background: Peritoneal metastasis (P) is the most life-threatening types of metastasis in patients with gastrointestinal cancer. Although the presence of tumor cells in peritoneal cavity is evaluated with microscopic observation by pathologists (Cy) or detection of mRNA of tumor specific molecules, no reliable method is available to quantify the accurate volume of tumor cells. Methods: Acsites or peritoneal lavages were recovered from 72 patients who underwent abdominal surgery for gastrointestinal cancer. In patients who received intraperitoneal (IP) chemotherapy for peritoneal metastasis, 40 samples were obtained from subcutaneous intraperitoneal access port during the course of chemotherapy. In those 112 samples, cells were recovered by centrifugation, fixed and immunostained with mAbs to CD45 and to CD326 (EpCAM). Using FACS analysis, CD326(+)CD45(-) and CD45(+)CD326(-) cells were determined as tumor cells (T) and leukocytes (L), respectively, and T/L ratio was calculated. Results: In 72 patients with surgery, Median (M) of T/L ratio of the P(+) patients was 15.3% (0%-751.3%), which was significantly higher than P(-) patients (M=0%, 0%-2.1%, p&lt;0.001). In P1 patients, 50 samples which was determined as positive cytology (Cy+) showed higher T/L ratio as compared with 33 samples with Cy (-) (M=23.0%, 0.3%-751.3% vs M=0.53%, 0%-3.5%, p&lt;0.0001). In 17 patients who underwent IP chemotherapy, T/L ratio was markedly decreased after chemotherapy (M=75%, 0.2%-339.0% vs M=0.16%, 0%-35.0%, p&lt;0.0001) and the response was more sensitive than Cy. Moreover, the MST of the 21 P1 patients who showed T/L ratio less than 10% at initial examination was 459 days, while MST of 8 P1 patients whose CT/L ratio was more than 10% was 188 day (p&lt;0.0012). Conclusions: T/L ratio measured with flowcytometry well reflects the total volume of intraperitoneal tumor cells and could be a reliable biomarker to predict the prognosis as well as effectiveness of IP chemotherapy in P1 patients in gastrointestinal cancer.

Abstract 4227: Sensitizing resistant ovarian cancer to chemotherapy through inhibition of small GTPases

Abstract Platinum- or paclitaxel-resistance is a major problem in women with advanced ovarian cancer (OVCA) and that confers a poor prognosis for patients. Consequently there is a great need to identify new drugs and drug targets for the management of residual and recurrent metastatic OVCA. About 90% of OVCA starts on the ovarian surface epithelium, but individual cells or multicellular aggregates (MCAs) shed into the peritoneal cavity and contribute to OVCA's metastasis into adjacent organs. These MCAs are resistant to apoptosis and to radio- and chemo-therapy. In OVCA, resistance to chemotherapy and apoptosis has been linked to the small GTPases, Rac1 and Cdc42, and their downstream effectors. Identifying compounds that disperse MCAs through disrupting adhesions would sensitize this resistant subpopulation to chemotherapy. We hypothesize that inhibition of one or both of these GTPases disrupts MCAs and sensitizes drug-resistant OVCA cells to respond to chemotherapeutic agents. We assessed if chemical inhibition of Rac1 or Cdc42 would sensitize drug-resistant OVCA monolayers and in vitro MCAs to cisplatin's cytotoxicity. The OVCA cell lines evaluated were OVCA 429 and SKOV-3ip. The inhibitors we used included: (1) NSC 23766, a Rac1-specific inhibitor, (2) ML141, a Cdc42-specific inhibitor, (3) Toxin B, an inhibitor of Rac, Cdc42 and Rho, and (4) R-naproxen, an inhibitor of Rac1 and Cdc42 (based on our data). We found that Rac1 and Cdc42 inhibitors disperse MCAs in a liquid overlay assay. Furthermore, these inhibitors sensitized OVCA cells to cisplatin's cytotoxic effect. Finding drugs that increase efficacy of chemotherapeutic agents against resistant OVCA cell populations is of particular importance. Thus far, GTPases have not been extensively examined as therapeutic targets, but they offer new opportunities for OVCA therapy. Our findings indicate that Rac1 and Cdc42 inhibitors disperse MCAs and improve their response to chemotherapeutic agents. This could increase the effectiveness of intraperitoneal chemotherapy and improve patient outcomes and survival. Since one of these inhibitors is R-Naproxen (an FDA approved off-patent drug), it has potential for rapid clinical application. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4227. doi:1538-7445.AM2012-4227

Effects of Intraperitoneal Chemotherapy with Mitomycin C on the Prevention of Peritoneal Recurrence in Colorectal Cancer Patients with Positive Peritoneal Lavage Cytology Findings

The detection of intraperitoneal free cancer cells in colorectal cancer (CRC) patients is associated with a poorer prognosis. The aim of this study was to investigate the effects of intraperitoneal chemotherapy (IPC) with mitomycin C (MMC) on preventing peritoneal recurrence in CRC patients with positive peritoneal lavage cytology findings. A total of 52 CRC patients who had no clinically confirmed peritoneal dissemination and whose status of peritoneal lavage cytology was positive were investigated. Conventional peritoneal lavage cytology was performed. Overall, 31 of the 52 patients (59.6%) were administered IPC with MMC. Before closure of the abdomen, 4 silicon catheters were inserted into peritoneal cavity. After closure, the perfusate (diluting 20 mg MMC with 500 ml saline) was instilled from the catheter, and all catheters were clumped. All catheters were opened 1 h later. The mean follow-up period was 83.1 months. According to univariate analyses of all 52 patients and the subgroup of 36 patients with stage II or III tumors, patients with IPC had a significantly better peritoneal recurrence-free survival and cancer-specific survival than patients who did not receive IPC (P < 0.005). In multivariate analysis, IPC remained an independent prognostic factor for peritoneal recurrence-free survival in all patients. It appears that IPC with MMC is an effective treatment to prevent peritoneal recurrence and prolong the cancer-specific survival in CRC patients without peritoneal dissemination, but who have positive peritoneal lavage cytology. It is necessary to verify the effectiveness of IPC with MMC in a prospective trial.

1248: Effects of Intraperitoneal Chemotherapy on Uterine Blood Flow in Patients with Postmenopausal Cervical Carcinoma Evaluated by Color Doppler Ultrasonography

1248: Effects of Intraperitoneal Chemotherapy on Uterine Blood Flow in Patients with Postmenopausal Cervical Carcinoma Evaluated by Color Doppler Ultrasonography