Problems with intraoperative hyperthermic peritoneal chemotherapy for advanced gastric cancer

Background: Intraoperative hyperthermic peritoneal chemotherapy (IHPC) after total gastrectomy for advanced, serosa-penetrating gastric cancer has been demonstrated in several studies to reduce the incidence of peritoneal carcinosis and to prolong survival, Methods: In a prospective pilot study, nine patients with advanced gastric cancer were selected to receive II-IPC with Mitomycin and Cisplatin after total gastrectomy and systematic lymphadenectomy. Results: All patients had nodal, and four patients distant. metastases. Six patients (66%) suffered from post-operative complications including renal failure, pancreatitis. pancreatic fistula and anastomotic dehiscence. Thirty-day mortality was zero. Six patients died within 3-10 months after surgery, Five of these deaths were related to peritoneal carcinosis and one patient died from cardiac failure 3 months after surgery. Three patients. respectively, have been alive for 12, 70 and 24 months at present, with suspected peritoneal tumour in the last patient, Thc l-year probability of survival among our patients receiving IHPC is 29%. Conclusion: Intraoperative hyperthermic peritoneal chemotherapy carries a high risk of peri-operative complications and was nor able to prevent or delay peritoneal tumour recurrence in patients with advanced gastric cancer.