Efficacy and Safety of Intraoperative Mesenchymal Chemotherapy with 5-Fluorouracil Release Formulation in Radical Gastrectomy of Advanced Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DONG Chunlu , CHAI Chen , LI Qiang , LI Debang , CAO Nong

Department of General Surgery， The First Hospital of Lanzhou University， Lanzhou 730000， Gansu Province， China;

Corresponding author：

Keywords：

Advanced gastric carcinoma; Fluorouracil implants; Local recurrence rates

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Objective 　To evaluate the efficacy and safety of intraoperative mesenchymal chemotherapy with 5-FU implants in radical gastrectomy of advanced gastric cancer.
Methods 　From January 2008 to September 2009， 102 patients with historically proven advanced gastric cancer were enrolled in our department and were allocated to undergo either radical gastrectomy and intraoperative mesenchymal chemotherapy with 5-FU implants 800 mg（treatment group， n=51）， or radical gastrectomy alone （control group， n=51）. The postoperative complications and recurrence rate between two groups were compared.
Results 　There were no significant differences on the volume of abdominal cavity drainage， count of white blood cells， albumin level， and gastrointestinal adverse events between the two groups （P＞0.05）. After a median follow-up of 28 months， the local recurrence rate was lower among patients in treatment group than that in control group （16.3% vs. 39.1%， P＜0.05）， the survival rate of 3-year was higher in treatment group than that in control group （85.8% vs. 67.3%， P＜0.05）.
Conclusions 　Compared with the control group， there are no significant adverse reactions on patients with advanced gastric cancer who were implanted fluorouraci1 implants during operation， which can reduce local recurrence rates and improve the survival rates.

Citation： DONG Chunlu,CHAI Chen,LI Qiang,LI Debang,CAO Nong,.. Efficacy and Safety of Intraoperative Mesenchymal Chemotherapy with 5-Fluorouracil Release Formulation in Radical Gastrectomy of Advanced Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 292-296. doi: Copy

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1. 张启瑜. 钱礼腹部外科学 [M]. 第1 版. 北京：人民卫生出版社， 2006： 240-241.
2. Ohtsu A， Yoshida S， Saijo N. Disparities in gastric cancer chemotherapy between the East and West [J]. J Clin Oncol， 2006，24(14)：2188-2196.
3. 刘福坤，姚学权. 胃癌的新辅助化疗 [J]. 中国普外基础与临床杂志， 2006， 13(1)：17-20.
4. 陈军，尹浩然，林言箴. 腹腔化疗对胃癌细胞腹腔种植的影响 [J]. 肿瘤， 1998， 18(04)： 264-266.
5. Sugarbaker PH. Adjuvant intraperitoneal chemotherapy for advanced primary gastric cancer [J]. Scand J Surg， 2006， 95(4)：270-273.
6. 庞君豪. 进展期胃癌术中区域化疗研究现状 [J]. 中国普外基础与临床杂志， 2010， 17(2)： 205-208.
7. 朱正纲. 胃癌术后复发的有关问题及综合治疗 [J]. 中国实用外科杂志， 2005， 25(3)： 181-183.
8. Yamamoto M， Baba H， Kakeji Y， et al. Prognostic significance of tumor markers in peritoneal lavage in advanced gastric cancer [J]. Oncology， 2004， 67(1)： 19-26.[9] Sugarbaker PH， Cunliffe W， Belliveau J， et al. Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer [J]. Semin Oncol，1989， 16(4 Suppl 6)： 83-97.
9. 朱正纲. 胃癌术后复发的外科综合治疗 [J]. 中华胃肠外科杂志， 2003， 6(6)：357-359.
10. Seshadri RA， Jayanand SB， Ranganathan R. Prognostic factors in patients with node-negative gastric cancer： an Indian experience [J]. World J Surg Oncol， 2011， 9： 48.
11. 何涛. 胃癌腹膜播散转移机理的研究进展 [J]. 中国普外基础与临床杂志， 2005， 12(1)：43-45.
12. 刘流，庄文，陈忠，等. 消化道恶性肿瘤患者术中腹腔内植入5-FU 缓释剂的安全性研究 [J]. 中国普外基础与临床杂志，2010， 12(2)：170-174.
13. 李俊玲，张传孝. 胃癌术后腹腔温热化疗与静脉化疗对术后局部复发的影响 [J]. 中国医学创新， 2011， 8(27)： 32-33.
14. Nesher E， Greenberg R， Avital S， et al. Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy in peritoneal carcinomatosis[J]. Isr Med Assoc J， 2007， 9(11)： 787-790.
15. 施敦，张邹赵. 胃癌术后复发及其相关因素分析 [J]. 中华胃肠外科杂志， 2004， 7(4)： 282-285.
16. Klaver YL， Hendriks T， Lomme RM， et al. Intraoperative versus early postoperative intraperitoneal chemotherapy after cytoreduction for colorectal peritoneal carcinomatosis： an experimental study [J]. Ann Surg Oncol， 2011 Aug 12. [Epub ahead ofprint].
17. 陈志新. 胃癌的腹腔内种植性转移与热灌注化疗 [J]. 普外基础与临床杂志， 1997， 4(1)：56-58.
18. Ströhlein MA， Bulian DR， Heiss MM. Clinical efficacy of cytoreductive surgery and hyperthermic chemotherapy in peritoneal carcinomatosis from gastric cancer [J]. Expert Rev Anticancer Ther， 2011， 11(10)：1505-1508.
19. López-Basave HN， Morales-Vásquez F， Ruiz Molina JM， et al. Morbidity and mortality of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy： national cancer institute，Mexico city， Mexico [J]. ISRN Oncol， 2011， 2011：526384.
20. Spiliotis JD， Halkia EA， Efstathiou E. Peritoneal carcinomatosis 2011； it’s about time for chemosurgery [J]. J BUON， 2011，16(3)： 400-408.
21. Roukos DH， Kappas AM. Limitations in controlling risk for recurrence after curative surgery for advanced gastric cancer are now well-explained by molecular-based mechanisms [J]. Ann Surg Oncol， 2001， 8(8)： 620-621.
22. Zippelius A， Pantel K. RT-PCR-based detection of occult disseminated tumor cells in peripheral blood and bone marrow of patients with solid tumors. An overview [J]. Ann N Y Acad Sci，2000， 906(1)： 110-123.
23. Miyazono F， Natsugoe S， Takao S， et al. Surgical maneuvers enhance molecular detection of circulating tumor cells during gastric cancer surgery [J]. Ann Surg， 2001， 233(2)： 189-194.
24. 刘爱国，梅蔚德，许健健，等. 缓释植入化疗药物的临床研究进展 [J]. 癌症进展， 2004， 2(4)： 270-276.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Efficacy and Safety of Intraoperative Mesenchymal Chemotherapy with 5-Fluorouracil Release Formulation in Radical Gastrectomy of Advanced Gastric Cancer

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