Society of University Surgeons| Volume 52, ISSUE 1, P232-239, July 1962

Intraluminal visceral perfusion as adjuvant chemotherapy to surgery for gastrointestinal cancer

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      Fifty cases of cancer, including stomach, duodenum, and colorectum, have been studied with HN2 injected intraluminally at operation at a dose of 0.4 mg. per kilogram in 29 patients and 0.8 mg. per kilogram in 21 cases. There was rapid absorption of HN2 in the colorectum cases. In the stomach there was proved absorption in only one of 3 cases. Technical difficulties in drawing blood samples from the efferent veins precluded data in the other cases. There was no apparent increase in morbidity or mortality rates in the group which had received 0.4 mg. per kilogram, but there was toxicity with a marked increase in mortality in the group receiving 0.8 mg. per kilogram of HN2. Absorption of HN2 is through critical areas at a time when the majority of viable cancer cells are probably traversing these routes. One case of cancer of the rectosigmoid has been presented with some experimental background in a new series utilizing 5-FU; absorption is again rapid. Our technique of adjuvant chemotherapy adds little time to the standard operative procedure. It is economical, simple, and may be an effective method for increasing survival rates. It is our hope that it will be tried by other workers in this field and adapted for newer and more effective drugs as they are developed.
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