Clinical outcome of intraoperative pelvic hyperthermochemotherapy for patients with Dukes' C rectal cancer

Abstract

In attempts to prevent local recurrence after curative resection for rectal cancer, intraoperative pelvic hyperthermochemotherapy (IOPHC) was prescribed for 27 patients with Dukes' C cancer. The procedures used were as follows: immediately after amputation or resection of the rectum with extended lymphadenectomy, the pelvic cavity was filled with physiological saline containing 40 µg/ml mitomycin C, which was warmed at 45°C for 90 min with an apparatus devised for IOPHC. Thirty-five patients who underwent surgery alone for Dukes' C rectal cancer within the same period served as controls. There was a local recurrence in three patients in the IOPHC group (11 · 1 %), and in 13 in the control group (37 · 1 %). With regard to hepatic or pulmonary metastasis, there was no differerence between the two groups. There was no morbidity in the IOPHC treatment except for a large volume of exudate from the pelvic cavity. Thus, IOPHC can be considered as one option for limiting local recurrence after surgical resection of an advanced rectal cancer.

Key Words:

• Pelvic hyperthermochemotherapy
• rectal cancer
• local recurrence