A proposal of a practical and optimal prophylactic strategy for peritoneal recurrence - PubMed (original) (raw)
A proposal of a practical and optimal prophylactic strategy for peritoneal recurrence
Masafumi Kuramoto et al. J Oncol. 2012.
Abstract
Peritoneal metastasis, which often arises in patients with advanced gastric cancer, is well known as a miserable and ill-fated disease. Once peritoneal metastasis is formed, it is extremely difficult to defeat. We advocated EIPL (extensive intraoperative peritoneal lavage) as a useful and practical adjuvant surgical technique for those gastric cancer patients who are likely to suffer from peritoneal recurrence. In this paper, we review the effect of EIPL therapy on prevention of peritoneal recurrence on patients with peritoneal free cancer cells without overt peritoneal metastasis (CY+/P-) through the prospective randomized study, and we verified its potential as an optimal and standard prophylactic therapeutic strategy for peritoneal recurrence.
Figures
Figure 1
Schema of “limiting dilution method.” This method is expected to lead to a logarithmic reduction of numerous cancer cells to zero.
Figure 2
Changes in numbers of intraperitoneal free cancer cells in five gastric cancer patients with CY+ treated by EIPL therapy. The numbers of free cancer cells in 100 mL of samples from the lavage fluid using 1 liter of saline were measured by ulra-rapid RT-PCR. The free cancer cells were serially diluted by 6 to 8 liters of saline and disappeared in washing fluid after that.
Figure 3
The survival curves for the 88 patients stratified according to the treatments. *By log-rank test.
Figure 4
A practical and optimal treatment protocol for advanced gastric cancer. D2 operation: gastrectomy with dissection of group 1 and 2 lymph node [37], N(+): positive lymph node metastasis through operation, N(−): no evidence of lymph node metastasis, PCR: real-time reverse transcriptase-polymerase chain reaction, EIPL: extensive intraoperative peritoneal lavage, IPC: intraperitoneal chemotherapy.
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