Role of peritoneal lymphatics for peritoneal metastasis and chemotherapy with mitomycin C bound to activated carbon particles

Toshio Takahashi, Akeo Hagiwara, Masataka Shimotsuma, Kiyoshi Sawai, Toshiharu Yamaguchi

doi:10.1007/bf02602247

Background Based on the knowledge that omental milky spots take up cancer cells seeded in the peritoneal cavity as well as carbon particles, mitomycin C bound to activated carbon particles (MMC-CH) was examined in patients with advanced gastric cancer in a prospective randomized study. Methods 104 patients who underwent gastrectomy for gastric cancer with definite serosal involvement were entered in this trial. Patients in the MMC-CH group were given 50 mg mitomycin C as MMC-CH dispersed throughout the peritoneal cavity just before surgical closure. Results 3-year survival rates for all-over patients treated with MMC-CH was 48% and for patients without MMC-CH was 28%, the differences between these 2 groups being significant (p<0.05). In the patients with macroscopic peritoneal carcinomatosis, there was no difference in survival between these 2 groups. There were no operative deaths in this series but bowel fistula developed in 2 patients given MMC-CH. Conclusions Chemotherapy with MMC-CH improves the survival of patients with gastric cancer involving the serosa, but does not improve the survival of patients with evidence of macroscopic peritoneal carcinomatosis.

Role of peritoneal lymphatics for peritoneal metastasis and chemotherapy with mitomycin C bound to activated carbon particles

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