Summary
Background
Local recurrence after surgery for patients with advanced gastric cancer and rectal cancer is often fatal. In an attempt to prevent local recurrences, we carried out intracavitary hyperthermic chemoperfusion (IHCP) combined with surgery.
Methods
60 patients with advanced gastric cancer and 27 patients with advanced rectal cancer were treated with IHCP plus surgery and, 52 and 35 patients with advanced gastric and rectal cancer, respectively, were treated by surgery alone.
Results
In case of rectal cancer, the incidence of local recurrence in the IHCP group is 3/27 patients (11.1%) and that in the control group is 13/35 patients (37.1%), thus differences between the groups are significant at p=0.043. With regard to gastric cancer, 13/60 patients (21.7%) in the IHCP group had a peritoneal recurrence and in the control group 40/52 patients (76.9%) had a recurrence; the statistical difference between the groups being significant (p=6.43 × 10−9).
Conclusions
IHCP treatment can diminish the incidence of local recurrence after surgical treatment for patients with advanced gastric or rectal cancer.
Zusammenfassung
Grundlagen
Lokale Rezidive nach Operation bei Patienten mit weit fortgeschrittenem Magen-oder Rektumkrebs sind meistens fatal. In einem Versuch, lokale Rezidive zu verhindern, haben wir in Verbindung mit Operationen eine intrakavitäre, hyperthemische Chemoperfusion (IHCP) durchgeführt.
Methodik
60 Patienten mit fortgeschrittenem Magenkrebs und 27 Patienten mit fortgeschrittenem Rektumkrebs wurden sowohl mit IHCP als auch operativ behandelt. Außerdem wurden jeweils 52 und 35 Patienten mit fortgeschrittenem Magen- und Rektumkrebs ausschließlich operativ behandelt.
Ergebnisse
Bei Rektumkrebs betrug die Häufigkeit lokaler Rezidive in der IHCP-Gruppe 3 von 27 Patienten (11,1%) und in der Kontrollgruppe 13 der 35 Patienten (37,1%). Der Unterschied zwischen den beiden Gruppen ist somit signifikant (p=0,043). In der Gruppe der Patienten mit Magenkrebs fanden sich bei 13 der 60 Patienten (21,7%) der IHCP-Gruppe peritoneale Rezidive, während in der Kontrollgruppe bei 40 der 52 Patiente (76,9%) auftraten. Die statische Differenz zwischen den beiden Gruppen war somit signifikant (p=6.43×10−9).
Schlußfolgerungen
Die IHCP-Behandlung kann die Häufigkeit lokaler Rezidive nach operativer Behandlung bei Patienten mit fortgeschrittenem Magen- oder Rektumkrebs herabsetzen.
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Fujimoto, S., Takahashi, M., Mutou, T. et al. Intracavitary hyperthermic chemoperfusion in patients with far-advanced gastric cancer or rectal cancer. Acta Chir Austriaca 27, 84–86 (1995). https://doi.org/10.1007/BF02602249
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DOI: https://doi.org/10.1007/BF02602249