Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Complications of intraperitoneal therapy with carbon-adsorbed mitomycin c for gastric cancer - results of a randomised controlled trial

M Jansen MD 1, J Fass MD 1, K Zengel 2, TH Reineke 3, V Schumpelick MD 1

Dept Surgery1, Pharmaceutical Services2 and Institute of Biometry 3, University Clinic, Rheinisch-Westfalische Technische Hochschule, Aachen, Germany,

AIM: The intraperitoneal application of carbon adsorbed Mitomycin C is likely to influence peritoneal seeding of gastric carcinoma, but no details are known about possible complications. METHODS: In a prospective randomized trial patients with gastric carcinoma and serosal invasion were randomized into a „therapy“- or „control- protocol“ after R0- or palliative-resection without additional cytoreductive surgery. The MMC-CH solution was dispersed throughout the abdominal cavity. Postoperative complications and oncologic results were registered continuously. RESULTS: 71 patients entered the study between 8/92 and 9/97, 64 were eligible. The results indicate, that MMC-CH-therapy causes little systemic toxicity and no increase of mortality, but it enhances the rate of intraabdominal infections (9/33 vs. 2/31, p<0,01) and reoperations (5/33 vs. 0/31, p<0,05). The median survival rates indicate a possible prophylactic effect following R0-resection but no benefit for the palliative procedures. CONCLUSIONS: Intraperitoneal MMC-CH-therapy leads to a not significantly prolonged survival time in cases of prophylactic treatment. However, the treatment is associated with an increase of intraabdominal septic complications. Therefore the palliative protocol was withdrawn.

KEY WORDS: gastric carcinoma.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on chemotherapy.