Intraperitoneal Perfusion Chemotherapy Research Articles

Port-Site Metastases and Chimney Effect of B-Ultrasound-Guided and Laparoscopically-Assisted Hyperthermic Intraperitoneal Perfusion Chemotherapy.

PurposeCO2 leakage along the trocar (chimney effect) has been proposed to be an important factor underlying port-site metastasis after laparoscopic surgery. This study aimed to test this hypothesis by comparing the incidence of port-site metastasis between B-ultrasound-guided and laparoscopically-assisted hyperthermic intraperitoneal perfusion chemotherapy (HIPPC).Materials and MethodsSixty-two patients with malignant ascites induced by gastrointestinal or ovarian cancer were divided into two groups to receive either B-ultrasound-guided or laparoscopically-assisted HIPPC. Clinical efficacy was assessed from the objective remission rate (ORR), the Karnofsky Performance Status (KPS) score, and overall survival. The incidence of port-site metastasis was compared between the two groups.ResultsPatients in the B-ultrasound (n=32) and laparoscopy (n=30) groups were comparable in terms of age, sex, primary disease type, volume of ascites, and free cancer cell (FCC)-positive ascites. After HIPPC, there were no significant differences between the B-ultrasound and laparoscopy groups in the KPS score change, ORR, and median survival time. The incidence of port-site metastasis after HIPPC was not significantly different between the B-ultrasound (3 of 32, 9.36%) and laparoscopy (3 of 30, 10%) groups, but significantly different among pancreatic, gastric, ovarian, and colorectal cancer (33.33, 15.79, 10.00, and 0.00%, p<0.001).ConclusionThe chimney effect may not be the key reason for port-site metastasis after laparoscopy. Other factors may play a role, including the local microenvironment at the trocar site and the delivery of viable FCCs (from the tumor or malignant ascites) to the trauma site during laparoscopic surgery.

The factors affecting the survival and prognosis of patients with III~IV gastric cancer: a report of 156 cases

Objective To investigate the factors affecting the survival and prognosis of patients with stage Ⅲ~Ⅳgastric cancers. Methods A total of 156 cases of Ⅲ~Ⅳ gastric cancer was studied retrospectively from September 1, 2006 to December 31, 2012. Kaplan-Meier analysis, Log-rank univariate analysis, Cox proportional hazards model analysis were used to analyze survival and prognostic factors. Results Twelve cases were lost, to the end of the follow-up, 22 cases were alive. The median survival time was 29.3 months. 1-year, 3-year, and 5-year overall survival rates were 83.3%, 37.8%, and 21.2%, respectively. Univariate analysis showed that tumor size, tumor node metastasis (TNM) staging, curative resection, hyperthermic intraperitoneal perfusion chemotherapy (HIPEC), and postoperative chemotherapy were correlated with prognosis (P<0.05 for all). Multivariate analysis showed that TNM staging, curative resection, HIPEC, and postoperative chemotherapy were independent prognostic factors (P<0.01 for all). Conclusions TNM staging, curative resection, hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy are the independent factors affecting the prognosis of stage Ⅲ~Ⅳ gastric cancer after resection. Hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy can improve their survival. Key words: Stomach neoplasms; Prognosis

Pathological complete response following neoadjuvant radiotherapy and intraperitoneal perfusion chemotherapy for recurrent colon carcinoma: A case report and literature review.

The present study reports the case of a 28-year-old male who was diagnosed with sigmoid colon carcinoma and exhibited local recurrence following radical surgery and 6 cycles of adjuvant chemotherapy. The primary surgery consisted of a partial sigmoidectomy and bladder repair. At 8 months post-chemotherapy, the patient was referred to Nanjing Drum Tower Hospital (Nanjing, China) due to local recurrence at the anastomotic site, which was confirmed by colonoscopy and total abdominal computed tomography. Synchronous intensity modulation radiation therapy and intraperitoneal (IP) perfusion chemotherapy with irinotecan (100 mg/m2) was administered. Following treatment, the object efficacy evaluation revealed a complete response and a second resection of the remaining sigmoid colon was performed. The post-operative results showed a pathological complete response. This case indicated that a combination of therapies, including radiotherapy, IP perfusion chemotherapy and surgery, may be beneficial and effective in patients with recurrent colon cancer.

The impact of neoadjuvant chemotherapy combined with tumor cell death and postoperative intraperitoneal chemotherapy on efficacy and quality of life of patients with ovarian cancer

Objective To observe the effect of neoadjuvant chemotherapy combined with tumor cells reduction and postoperative intraperitoneal perfusion chemotherapy on the efficacy and quality of life of ovarian cancer. Methods From October 2010 to October 2013 at the Department of gynecology, Taizhou Municipal Hospital, 65 cases of ovarian cancer patients for the treatment of stage Ⅲ and Ⅳ were randomly divided into intervention group (n=32) and control group (n=33). Patients in the intervention group received neoadjuvant chemotherapy after tumor cell reduction cytoreductive surgery and received postoperative intraperitoneal hyperthermic perfusion chemotherapy and conventional surgery after chemotherapy. Patients in the control group received conventional tumor cell cytoreductive surgery plus postoperative chemotherapy. Surgical status, the effectiveness of treatment, and adverse reactions were compared between two groups. Moreover, survival quality score, relapse rate, and mortality differences were compared between two groups. Results For the intervention group, operation status and effective treatment were better than the control group. The proportion of adverse reactions had no significant difference between two groups. Survival quality had no statistically significant difference between before treatment and after receiving treatment. Quality of life in the intervention group was better than that of the control group. Relapse rate, and mortality rate in the intervention group was lower than the control group. Conclusions Accepted neoadjuvant chemotherapy combined with tumor cytoreductive surgery and surgery after intraperitoneal hyperthermic perfusion chemotherapy can improve the effectiveness of treatment of ovarian cancers, and improve the quality of life, with better short-term effect. Key words: Chemotherapy, adjuvant; Tumor cells, cultured; Ovariectomy; Chemotherapy, cancer, regional perfusion; Ovarian neoplasms/TH; Quality of life

Laparoscopic Hyperthermic Intraperitoneal Perfusion Chemotherapy for Patients with Malignant Ascites Secondary to Unresectable Gastric Cancer

To compare the efficacy of three chemotherapeutic combinations for laparoscopic hyperthermic intraperitoneal perfusion chemotherapy (HIPPC) in the treatment of malignant ascites secondary to unresectable gastric cancer (GC). From January 2010 to December 2013, 38 GC patients were randomly divided into three groups and treated by laparoscopic HIPPC with one of the three following chemotherapy combinations: raltitrexed (Ra) with oxaliplatin [trans-(±)-diaminocyclohexane oxalatoplatinum (l-OHP)], Ra with cisplatin (DDP), and Ra with mitomycin C (MMC). Perioperative complications, patients' quality of life, and survival were recorded and compared among the three groups. The intraoperative course was successful in all patients, and no perioperative death or complication related to laparoscopic HIPPC was documented. The median follow-up period was 9 months, and the median survival was 7.5 months for all patients. Patients in the Ra/l-OHP group had a median survival of 8.7 months, the Ra/DDP group had a median survival of 5.6 months, and the Ra/MMC group had a median survival of 7.5 months. Patients' median survival in the Ra/l-OHP group and Ra/MMC group was significantly longer than in the Ra/DDP group (P < .05). No significant difference was found in total remission rate of ascites, increase in the Karnofsky Performance Scale, and incidence rate of port-site metastases among the three groups. Laparoscopy-assisted HIPPC provides modest yet encouraging efficacy for malignant ascites secondary to disseminated GC. Our preliminary data indicate that the chemotherapeutic combination of Ra/l-OHP and Ra/MMC might be more beneficial compared with Ra/DDP in terms of patients' survival.

Efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy for the treatment of malignant ascites: a midterm study of 36 patients.

BackgroundThis study aimed to evaluate the efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) for the treatment of malignant ascites (MA).MethodsBetween July 2011 and June 2013, 36 MA patients were prospectively and consecutively hospitalized for three cycles of elective CHIPC under ultrasound guidance, maintained at a constant flow rate of 400–600 mL/min normal saline containing 5-fluorouracil plus mitomycin or carboplatin and at a constant temperature of 43°C±0.2°C, for 90 minutes. Main outcome measures were ascites resolution, Karnofsky performance status (KPS), and serum tumor biomarkers at 2 weeks after the last cycle of CHIPC. All the patients underwent uneventful CHIPC as scheduled, and vital signs remained stable over CHIPC.ResultsAt 2 weeks after the last cycle of CHIPC, MA completely and partially resolved in 26 (72.2%) patients and eight (22.2%) patients, respectively; mean KPS score increased from pretreatment 61±9 to posttreatment 76±9 (P<0.001), and serum carcinoembryonic antigen and carbohydrate antigens 12-5 and 19-9 significantly decreased (all P<0.01).ConclusionThe current study indicated that ultrasound-guided CHIPC is an effective and safe palliative treatment modality for MA with respect to MA resolution, patient’s general well-being, and systemic disease control. The long-term benefit of CHIPC on overall survival remains to be investigated in MA patients.

Abstract CT130: Intravenous chemotherapy plus intraperitoneal perfusion chemotherapy for gastric cancer: A systematic review and meta-analysis

Abstract Purpose: This a review of randomized controlled trials (RCTs) of intravenous (IV) with or without intraperitoneal (IP) chemotherapy in patients with gastric cancer to determine the impact on effect and safety. Methods: Databases, including Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, Current Controlled Trials, and CINAHL were electronically searched for RCTs up to June 2013, and relevant references of the included articles were also manually searched. Two authors independently searched articles, extracted data, and assessed the quality of included studies. Meta-analyses were performed on the included data, for the outcomes survival rate, metastasis rate and adverse events. The Grading of Recommendations Assessment, Development and Evaluation System was used to rate the level of evidence. Results: Five RCTs involving 1072 patients were included. Overall, a significant improvement in overall survival rate [relative risk (RR) = 1.21, 95% confidence interval (95% CI) 1.13 to 1.29, P&amp;lt;0.01], one-year survival rate (RR = 1.10, 95% CI 1.04 to1.17, P = 0.005), three-year survival rate (RR = 1.22, 95% CI 1.11 to1.35, P = 0.001), and five-year survival rate (RR = 1.42, 95% CI 1.12 to 1.80, P = 0.004) were associated with IV plus IP chemotherapy. Meta-analysis demonstrated that metastasis rate can be effectively decreased (RR = 0.35, 95% CI 0.25 to 0.50, P&amp;lt;0.01) but incidence of adverse events were increased using IV plus IP chemotherapy. Conclusion: IV plus IP chemotherapy in patients with gastric cancer is associated with improved overall survival and prevented distant or peritoneal metastasis. However, increased risk of neutropenia, peripheral edema and neuropathy are also demonstrated. Citation Format: Sheng Yang, Rui Feng, Zhangchi Pan, Tao Jiang, Qian Xu, Qiang Chen. Intravenous chemotherapy plus intraperitoneal perfusion chemotherapy for gastric cancer: A systematic review and meta-analysis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr CT130. doi:10.1158/1538-7445.AM2015-CT130

Safety and efficacy of intraperitoneal hyperthermic perfusion chemotherapy following laparoscopic palliative resection for gastric cancer patients with peritoneal metastasis

To investigate the safety and efficacy of postoperative intraperitoneal hyperthermic perfusion chemotherapy(IHPEC) following laparoscopic palliative resection for advanced gastric cancer patients with peritoneal metastasis. Between March 2010 and October 2013, 37 patients with advanced gastric cancer were treated by IHPEC(cisplatin 100 mg, 5-fluorouracil 1000 mg and saline 2000 mL) following laparoscopic palliative resection in our department between March 2010 and October 2013 were analyzed retrospectively. Short-term efficacy and adverse reactions were observed. Complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD) were found in 18, 4, 8 and 7 cases respectively, and the total progression-free rate was 59.5%(22/37). The significant improved, improved, stable and progressive cases of Karnofsky performance status were 6, 13, 10 and 8 respectively, and the rate of improved and stable cases was 78.4% (29/37). Serious adverse reactions (class III ( or IIII) were noted in 3 cases (8.1%), including 2 cases of abdominal pain (class III), 1 case of nausea and vomiting. The modality of IHPEC adopting cisplatin plus 5-fluorouracil regimen following laparoscopic palliative resection for advanced gastric cancer patients with peritoneal metastasis is technically feasible and safe, which has certain effect on postponing the progression of gastric cancer.

Studies on assessment methods of malignant ascites residue and changes of verapamil concentration in intraperitoneal perfusion chemotherapy.

To establish a simple method for estimating residual peritoneal ascites in order to determine the optimum verapamil (VRP) initial concentration in the intraperitoneal perfusion chemotherapy. (1) Pelvic size of adults was assessed by measuring distance from the superior margin of pubic symphysis to the connecting line of two anterior superior spine (SL) and to the midpoint of the line (SM) in 172 adults; (2) 35 postoperative gastric or colon cancer patients with indications for use of preventive intraperitoneal chemotherapy were infused with 1,000-1,250 mL 0.9 % normal saline solution for about 15 min and used for perfusate detection by moving along the midpoint of connecting line of two anterior superior spine after 5 min of infusion; (3) The VRP concentration in ascites was detected by liquid chromatography. The distance between two anterior superior spines for adult were 29.6 ± 2.6 cm and the distance from the superior margin of pubic symphysis to the midpoint between two anterior superior spines was 10.6 ± 1.9 cm. When the total intraperitoneal infusion fluid was 1,000-1,250 mL, it could be detected by B-mode ultrasonic device at 0.1-0.3 cm directly below the midpoint of two anterior superior spines. The VRP reversal concentration of drug resistance could maintain for 90 min when the residual ascites volume was within the range of 1,000-1,250 mL. Detection of liquid at the position directly below or above the midpoint of two anterior superior spines by B-mode ultrasonic device in patients in erect position could be a simple method for estimation of ascites volume (liquid found at 0.1-0.3 cm directly below the midpoint of two anterior superior spines suggested that ascites volume was smaller than 1,000-1,250 mL). The method could be used for determination of VRP initial concentration for IPC treatment.

Effect of neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy on advanced gastric cancer

Neoadjuvant and hyperthermic intraperitoneal chemotherapies have been shown to be effective in the treatment of resectable advanced gastric cancer. The aim of the present study was to investigate the clinical efficiency and security of neoadjuvant chemotherapy in combination with hyperthermic intraperitoneal chemotherapy for the treatment of postoperative advanced gastric cancer. A total of 192 patients diagnosed with advanced gastric cancer were randomly divided into the following four groups (n=48 per group): Control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups. The joint group received neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy. Complications, adverse reactions, recurrence rates within 2 years and the 1- and 3-year survival rates following surgery were observed. No significant differences were observed in the occurrence rates of I–II degree myelosuppression, III–IV degree myelosuppression, I–II degree nausea or III–IV degree nausea and vomiting among the four groups (P>0.05). The median progression-free survival times were 26, 31, 33 and 28 months in the control, neoadjuvant chemotherapy, hyperthermic intraperitoneal perfusion chemotherapy and joint groups, respectively (P<0.001). Compared with the control group, the recurrence-free 2-year survival rate of the joint group was significantly lower (P=0.04). The difference among the median survival times of the four groups was statistically significant (P=0.001). The 1-year survival rate of the joint group was significantly higher when compared with the control group and the difference was statistically significant (P=0.03). However, no statistically significant difference was identified among the 1-year survival rates of the four groups (P>0.05). Compared with the control group, the 3-year survival rates of the other three groups were significantly higher (P<0.05). Therefore, the results of the present study indicated that neoadjuvant chemotherapy combined with hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer is well tolerated and exhibits improved compliance and efficiency.

Erratum to: Multivariate comparison of B-ultrasound guided and laparoscopic continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy for malignant ascites

Erratum to: Multivariate comparison of B-ultrasound guided and laparoscopic continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy for malignant ascites

Influence of systemic and intraperitoneal hyperthermic perfusion chemotherapy on serum VEGF and HE4 in patients with ovarian cancer

Objective To observe the influence of systemic and intraperitoneal hyperthermic perfusion chemotherapy on serum vascular endothelial growth factor(VEGF) and human epididymis protein 4 (HE4) in patients with ovarian cancer.Methods 116 cases with ovarian cancer were,randomly divided into the observation group and the control group according to the number table,58 cases in each group.The observation group was given systemic and intraperitoneal hyperthermic perfusion chemotherapy,and the control group received systemic chemotherapy,they all completed a total of two cycles of chemotherapy.Serum VEGF and HE4 were measured before and after chemotherapy.Results The total effective rate of the observation group was 74.1％,and that was 56.9％ of the control group,the difference was significant (x2 =4.290,P ＜ 0.05).After chemotherapy,the serum VEGF and HE4 were signifi cantly decreased in two groups,and compared with the control group,the observation group decreased more significantly(t =3.180,2.725,all P ＜ 0.05).Conclusion Systemic and intraperitoneal hyperthermic perfusion chemotherapy in treatment of patients with ovarian cancer can significantly reduce serum VEGF and HE4. Key words: Ovarian cancer; Chemotherapy; Vascular endothelial growth factor; Human epididymis protein 4

Uwagi praktyczne do śródoperacyjnej anestezji u pacjentów operowanych z zastosowaniem dootrzewnowej perfuzyjnej chemioterapii w warunkach hipertermii – seria 60 przypadków

Uwagi praktyczne do śródoperacyjnej anestezji u pacjentów operowanych z zastosowaniem dootrzewnowej perfuzyjnej chemioterapii w warunkach hipertermii – seria 60 przypadków

Clinical study of cisplatin hyperthermic intraperitoneal perfusion chemotherapy in combination with docetaxel, 5-flourouracil and leucovorin intravenous chemotherapy for the treatment of advanced-stage gastric carcinoma.

The purpose of this study is to observe and compare the preliminary efficacy and side effects of docetaxel, 5-fluorouracil and leucovorin intravenous chemotherapy in combination with cisplatin hyperthermic intraperitoneal perfusion chemotherapy for the treatment of advanced gastric cancer. Retrospectively analyzed 101 patients with advanced gastric cancer receiving docetaxel, 5-fluorouracil, leucovorin and cisplatin intravenous chemotherapy or intravenous administration of docetaxel, 5-fluorouracil and leucovorin combined with cisplatin hyperthermic intraperitoneal perfusion chemotherapy, 49 patients in intravenous chemotherapy (VC) group, 52 patients in hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) group. The response rate was 44.9% (22/49) in VC group and 65.4% (34/52) in HIPEC group, among which there was 1 case of CR, and the difference was statistically significant (p= 0.038). For CBR evaluation, the effective rate was 65.3% (32/49) in VC group and 82.7% (43/52) in HIPEC group, and the difference was statistically significant (p= 0.0458). The median progress free survival time (PFS) was 3.4 months in VC group and 4.6 months in HIPEC group, the difference was statistically significant (p= 0.045). The median overall survival time (OS) was 6.7 months in VC group and 7.5 months in HIPEC group, the difference was not statistically significant (p= 0.201). The main side effects in two groups were well tolerated, and there was no statistically significant difference. The short-term efficacy and PFS of HIPEC plus intravenous chemotherapy were better than single intravenous chemotherapy, and there was no significant improvement in OS, the side effects were similar in two groups with good tolerability.

Treatment of gestational choriocarcinoma and massive ascites by hypothermic intraperitoneal perfusion chemotherapy guided by ultrasound followed by cytoreductive surgery

A 33-year-old woman with very poor health status was admitted to our hospital because she had experienced increasing abdominal distention for three months, CT examination showed a right ovarian tumor together with massive abdominal and pelvic fluid. The patient was first treated by continuous circulatory hypothermic intraperitoneal perfusion chemotherapy (HIPC) guided by B-mode ultrasound, followed by cytoreductive surgery (CRS) after her ascites was controlled and her health condition improved. She was diagnosed with gestational choriocarcinoma (GC) based on the pathological examination of the hysterectomy specimen. She is still alive with very good health today. We think it may be a good choice for a patient in very poor health with GC accompanied by massive ascites to perform HIPC guided by B-mode ultrasound firstly, followed by CRS when the ascites has relieved and the patient's health has improved.

Multivariate comparison of B-ultrasound guided and laparoscopic continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy for malignant ascites

Clinical efficacy of B-ultrasound-guided and laparoscopy-assisted continuous hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) for treatment of malignant ascites was investigated. Sixty-two patients with malignant ascites induced by ovarian or gastrointestinal cancers were randomly treated with B-ultrasound-guided CHIPC (therapeutic group) or laparoscopy-assisted CHIPC (control group) performed at the same center. Hospitalization costs and surgical duration were evaluated. Follow-up was conducted for 21 months with B-ultrasound or computed tomography at least once per month for assessment of ascites amount and tumor progression. Clinical efficacy was assessed by modified World Health Organization criteria. Survival time, Karnofsky performance score (KPS) of quality of life (QOL), and complications were recorded for all patients. Overall condition, primary disease type, and ascites amounts were comparable between groups. Significantly shorter mean duration of perfusion catheter placement (35 vs. 85 min) and mean hospitalization cost (36,000 vs. 55,000 ¥/patient) were observed in the therapeutic group than the control group (P < 0.01). Significantly different KPS scores were not observed before or after CHIPC (23.13 vs. 22.64 %) in both groups (P > 0.05). No significant differences in objective remission rates of malignant ascites (93.75 vs. 93.34 %), median survival times (9 vs. 8 months), or stamp hole metastasis rates (18.75 vs. 18.15 %) were observed between groups (P > 0.05). B-ultrasound-guided and laparoscopy-assisted CHIPC have similar clinical efficacy for improving QOL and prolonging patient survival. B-ultrasound-guided CHIPC may, however, shorten operation times and reduce hospitalization costs, making the treatment available to a broader patient population, although port hole metastasis remains an issue.

Application of the meticulous care in intraperitoneal hyperthermic perfusion chemotherapy of gastrointestinal tumors

To investigate the application of meticulous care in intraperitoneal hyperthermic perfusion chemotherapy of gastrointestinal tumors.Methods In our hospital,meticulous care were given to 62 patients during,their intraperitoneal hyperthermic perfusion chemotherapy.Results All the 62 patients completed treatment successfully.There were no complications such as intestinal obstruction,piping around infection and pipeline off,infusion of the drug extravasation,burns and gastrointestinal adverse occurred.And the cognition of patients and families on the intraperitoneal hyperthermic perfusion chemotherapy was improved as well as their satisfaction degree to nursing.Conclusions The meticulous care can reduce the incidence of complications,improve the intraperitoneal hyperthermic perfusion chemotherapy safely,and improve patients 'satisfaction. Key words: Gastrointestinal tumors; Meticulous care; Intraperitoneal hyperthermic perfusion; Chemotherapy

B ultrasound-guided hyperthermic intraperitoneal perfusion chemotherapy for the treatment of malignant ascites

To minimize invasive surgery, we employed B ultrasound to guide the placement of the catheters used in continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in malignant ascites treatment. Thirty-two patients with malignant ascites were treated with CHIPC guided by B-mode ultrasound. Ascites were originally from ovarian cancer (11 cases), gastric cancer (10 cases), colorectal cancer (9cases) and pancreatic cancer (2 cases). The CHIPC was carried out at 43˚C for 90 min with 0.9% saline solution as a carrier containing cisplatin and doxorubicin or mitomycin-C as therapeutic reagents depending on the type of the primary tumor. The therapeutic efficacy, postoperative complications and survival period of these patients were assessed with follow-up examinations. Among all participates to be assessed with ascites, 26 and 4 patients showed complete remission (CR) and partial remission (PR) respectively, with an objective remission rate (ORR) of 93.75%. The KPS scores were elevated by 23.1±9.0 after 3 sessions of ultrasound guided CHIPC and the quality of life (QOF) of patients was significantly improved (p<0.01). The median survival time was 9months and 18 patients survived between 3 and 30 months after CHIPC treatment. Additionally, patients with different types of cancers significantly differed in the survival time (p<0.01). A novel approach of using B ultrasound guided CHIPC for the treatment of malignant ascites demonstrated satisfactory outcomes. The approach shows benefit in minimizing invasive surgery, improving the patient QOF and prolonging survival time.

Retrospective Analysis of Adjuvant Intraperitoneal Chemotherapy Effect Prognosis of Resectable Gastric Cancer

Objective: This study evaluated the efficacy and safety of adjuvant intraperitoneal perfusion chemotherapy (IPC) in resectable gastric cancer through retrospective analysis. Methods: Three hundred and sixty T2–4bN0–3M0 resectable gastric cancer patients were included in this study. One hundred and eighty-four patients used systemic chemotherapy combined with IPC (IP+ group) and 176 systemic chemotherapy only (IP– group). Results: With a median of 49.9 months of follow-up, the 5-year overall survival in IP+ patients was significantly better than in IP– patients (60.4 vs. 42.9%; p = 0.001), and the average progression-free survival in IP+ patients was significantly longer than in IP– patients (60.5 vs. 46.2 months; p = 0.001). Relapse rates of peritoneal carcinomatosis, celiac lymph node and hepatic metastasis in the IP+ patients were significantly lower than in the IP– patients. Patients with curative resection, a histological type other than mucinous adenocarcinoma and signet ring cell carcinoma, low and undifferentiated tumor grade, lymph node metastasis, and T3 and T4a benefited from adjuvant IPC. The toxicities were the same except for more patients with leukopenia in the IP+ group (p = 0.001). The number of cycles of IPC and the time of IPC start after surgery had an impact on overall and disease-free survival. Conclusion: Adjuvant IPC for resectable gastric cancer gave encouraging results and large multicenter prospective randomized controlled studies are warranted.

Literature review of the efficacy and safety of hyperthermic intraperitoneal perfusion chemotherapy after cytoreductive surgery in the treatment of pseudomyxoma peritonei

To evaluated the safety and efficacy of hyperthermic intraperitoneal perfusion chemotherapy(HIPC) in the prevention and treatment of pseudomyxoma peritonei (PMP) recurrence after cytoreductive surgery(CRS). Studies published in English before 2010 on HIPC after CRS for PMP were searched in PubMed database. Each study was carefully evaluated based on pre-determined criteria. Study results were comprehensively displayed in a form. A descriptive systematic review was performed. A total of 11 studies were included. The median survival time of patients in these studies ranged from 25.6 months to 156 months. The ranges of 1-year, 2-year, 3-year, 5-year, and 10-year survival rates were 72%-100%, 55%-96%, 59%-96%, 52%-96%, and 55%-96%, respectively. The overall complication rate ranged from 2%-15%, and the total perioperative mortality were from 0 to 7%. HIPC after CRS is effective and safe for patients with PMP.