Long-term survival of 5 years following initial surgery for gastric cancer and simultaneous disseminated peritoneal metastasis: Report of a case

Abstract

We report herein the rare case of a patient who survived for 5 years and 10 months after commencing treatment for gastric cancer with simultaneous disseminated peritoneal metastasis. A 45-year-old man was diagnosed as having advanced gastric cancer following the discovery of numerous nodules in the peritoneal cavity at laparotomy. The patient was treated by palliative gastrectomy and continuous hyperthermic peritoneal perfusion (CHPP) immediately after surgery on November 11, 1987. Postoperatively, he underwent radiofrequency (RF) hyperthermia with intraperitoneal cisplatin a total of seven times. He continued on a combination of uracil and tegafur (UFT) administered orally with a protein-bound beta-D-glucan extracted from the mycelia of Cariolus versicolor (PSK). Long-term survival was achieved following the initial palliative gastrectomy despite simultaneous disseminated peritoneal metastasis.

Palliative gastrectomy and chemotherapy for stage IV gastric cancer

“…No deWnite surgical policy has been established for the treatment of patients with simultaneous peritoneal metastasis (Otani et al 1995). Most of these patients have very poor prognosis and may die within 1 year irrespective of whether they undergo surgery or postoperative chemotherapy (Ohno et al 1994).…”

Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapy

“…However, homogeneous distribution of the perfusion fluid with a closed abdomen remains very uncertain (17,21). Other attempts to promote the distribution of the perfusion fluid include external massage of the abdomen and an increased flow rate of perfusion fluid (26,27).…”

Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis

“…Here lies the main problem of IPCH, and many attempts to enhance diffusion of both heat and drugs have been reported: vigorous external massage, 22 increase in inflow rates up to 500 mL/mn or more, 23 and use of a peritoneal cavity expander with an opened sterile circuit. 24 The abdominal cavity represents a complex and nonsystematized environment, 21 and experiences with multiple intraperitoneal thermal probes have clearly demonstrated the heterogeneity of the temperatures obtained.…”