human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The second British Stomach Cancer Group trial was a prospect i ve r and omised controlled trial of adjuvant radiotherapy or cytotoxic chemotherapy after gastrectomy for adenocarcinoma . It recruited between 1981 and 1986 . No survival advantage has been demonstrated for the patients receiving either type of adjuvant therapy compared with those undergoing surgery alone . We report on 436 patients r and omised into the trial together with 203 patients , who did not fulfil the trial criteria , referred to the trial . A univariate ( log-rank ) analysis of pathological factors obtained from the local referring centres showed that tumour size , macroscopic type , number os sites involved , depth of invasion , involvement of resection lines and lymph nodes and histological grade were significant determinants of survival . Histological review by two experienced histopathologists found that the Lauren classification and histological grade , but not the Ming classification , were significant prognostic factors . The degree of lymphocytic and eosinophilic infiltration and presence of dysplasia assessed by one of the pathologists showed a significant correlation with survival . However , inter-observer correlation for these histological parameters and grade was poor . Multivariate analysis identified only depth of invasion , resection line and nodal involvement as significant independent pathological variables influencing survival . This study confirms the need for expert preparation of the resected specimen to obtain the important information on depth of invasion and nodal status and also reveals some variation in histological assessment , particularly grading , in gastric carcinoma OBJECTIVE To evaluate the effects of continuous hyperthermic peritoneal perfusion ( CHPP ) together with st and ard chemotherapy on the prognosis of patients with gastric cancer invading the serosa . DESIGN Retrospective study . SETTING University hospital , Japan . SUBJECTS 174 patients who had undergone curative resection for gastric cancer invading the serosa ( T3 ) between 1980 and 1989 , 78 of whom had been r and omised to be treated with CHPP after operation and 96 who received st and ard chemotherapy .  INTERVENTIONS CHPP was done immediately after operation ; 8 - 10 l fluid containing 80 - 100 mg/m2 mitomycin C was perfused at a rate of 100 - 200 ml/minute , and inflow and out flow temperatures were maintained at 44 - 45 degrees C and 40 - 42 degrees C , respectively . This was followed by a st and ard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil ( 1:4 ) ( UFT ) . The control group received the st and ard regimen only . MAIN OUTCOME MEASURES Five year survival and patterns of recurrence in three groups : no lymph node metastases , 1 - 9 , and 10 or more . RESULTS Only in the group with 1 - 9 lymph node metastases was there an appreciable but not significant difference in 5 year survival : 66 % compared with 44 % ( p = 0.084 ) . The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls . CONCLUSION CHPP improved prognosis in patients with T3 gastric cancer who had only 1 - 9 metastatic lymph nodes Background This r and omized phase III study was to evaluate the efficacy and safety of cytoreductive surgery ( CRS ) plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) for the treatment of peritoneal carcinomatosis ( PC ) from gastric cancer . Methods Sixty-eight gastric PC patients were r and omized into CRS alone ( n = 34 ) or CRS + HIPEC ( n = 34 ) receiving cisplatin 120 mg and mitomycin C 30 mg each in 6000 ml of normal saline at 43 ± 0.5 ° C for 60–90 min . The primary end point was overall survival , and the secondary end points were safety profiles . Results Major clinicopathological characteristics were balanced between the 2 groups . The PC index was 2–36 ( median 15 ) in the CRS + HIPEC and 3–23 ( median 15 ) in the CRS groups ( P = 0.489 ) . The completeness of CRS score ( CC 0–1 ) was 58.8 % ( 20 of 34 ) in the CRS and 58.8 % ( 20 of 34 ) in the CRS + HIPEC groups ( P = 1.000 ) . At a median follow-up of 32 months ( 7.5–83.5 months ) , death occurred in 33 of 34 ( 97.1 % ) cases in the CRS group and 29 of 34 ( 85.3 % ) cases of the CRS + HIPEC group . The median survival was 6.5 months ( 95 % confidence interval 4.8–8.2 months ) in CRS and 11.0 months ( 95 % confidence interval 10.0–11.9 months ) in the CRS + HIPEC groups ( P = 0.046 ) . Four patients ( 11.7 % ) in the CRS group and 5 ( 14.7 % ) patients in the CRS + HIPEC group developed serious adverse events ( P = 0.839 ) . Multivariate analysis found CRS + HIPEC , synchronous PC , CC 0–1 , systemic chemotherapy ≥ 6 cycles , and no serious adverse events were independent predictors for better survival . Conclusions For synchronous gastric PC , CRS + HIPEC with mitomycin C 30 mg and cisplatin 120 mg may improve survival with acceptable morbidity n= 16 ) ; intraoperative chemotherapy and UFT 300 mg/day ( P1 group , n= 13 ) ; or UFT 600 mg/day ( P2 group , n= 17 ) . Patients with an intestinal type of cancer were r and omly assigned to one of three treatment groups : H0 ( n= 17 ) , H1 ( n= 12 ) , and H2 ( n= 12 ) ; each group was subjected to the same protocol s as the P0 , P1 , and P2 groups , respectively , except for the MMC administration route . MMC ( 10 mg/patient ) was administered intraoperatively into the intraperitoneal cavity ( P1 and P2 groups ) or the portal vein ( H1 and H2 groups ) . All patients underwent curative resection . Background factors did not differ significantly among the treatment groups . The overall survival rates were progressively worsened in the order of P2 , P1 , and P0 or H2 , H1 , and H0 , respectively . The survival rate of the P2 group was statistically higher than that of the P0 group ( p < 0.05 ) . The intermediate-term survival rate of the P2 group or H2 group was significantly higher than that of the P0 group ( p < 0.05 ) or H0 group ( p < 0.05 ) , respectively . These results suggest the effectiveness of this therapy and the possible eradication of potential micrometastatic foci outside the surgical field by the direct administration of chemotherapeutic agents to the predicted recurrence site PURPOSE Previous studies have demonstrated a beneficial effect of intraperitoneally applied mitomycin bound to activated carbon particles ( M-CH ) in preventing intraabdominal recurrence following curative surgery for gastric cancer . The Austrian Working Group for Stomach Cancer , a subgroup of the Austrian Working Group for Surgical Oncology , initiated a multicentric phase III trial to evaluate the safety and efficacy of this treatment regimen . PATIENTS AND METHODS A total of 91 patients with a radically resected gastric cancer infiltrating the serosal surface were r and omly assigned to receive either 50 mg mitomycin bound to a solution of 375 mg carbo adsorbens intraperitoneally before closure of the abdominal wound ( n = 46 ) or served as a surgical control group ( n = 45 ) . Postoperative complications and recurrence-free and overall survival were evaluated to analyze the risks and benefits of this treatment . RESULTS After a median observation period of 597 days ( range , 72 to 1,096 ) , a significantly higher postoperative complication rate was observed in the M-CH group ( 35 % ) compared with the control group ( 16 % ) ( P < .02 ) . In accordance with this finding , the postoperative ( 60 days ) mortality rate was also significantly elevated in the M-CH group ( 11 % v 2 % in the control group ) . Since analysis of overall and recurrence-free survival failed to show any beneficial effect of M-CH therapy , the protocol committee decided to stop further recruitment of patients onto this study . CONCLUSION Adjuvant intraperitoneal therapy of gastric cancer by mitomycin bound to activated carbon particles is associated with an increased rate of postoperative complications . However , no benefit for prognosis following radical resection of locally advanced tumors was observed in this multicenter phase III trial A novel method of prophylaxis and treatment for peritoneal carcinomatosis — mitomycin C bound to activated carbon particles (MMC-CH)—was tested in patients with advanced gastric cancer in a prospect i ve r and omized study . Activated carbon particles are taken up selectively by lymphatic tissues , which seem to be a primary site of peritoneal carcinomatosis in the peritoneal cavity , and adsorb a large amount of anticancer agent mitomycin C , which is subsequently released slowly and for a protracted period . A group of 113 patients who underwent radical resection for gastric cancer with definite serosal involvement were entered in this trial . Those in the control group received no intraperitoneal anticancer drugs . Patients in the MMC-CH group were given 50 mg mitomycin C as MMC-CH , which was dispersed throughout the peritoneal cavity just before surgical closure . No other anticancer drugs were given to these patients after surgery . The 2- and 3-year survival rates for the MMC-CH group were 42 % and 38 % , respectively ; and the rates for the control group were 28 % and 20 % , respectively . The difference in survival between the two groups was significant at 2 and 3 years ( p<0.05 ) . For the survival of patients with macroscopic peritoneal carcinomatosis , there was no difference between these two groups . For the survival of patients who underwent histologically curative resection , 2- and 3-year survivals for the MMC-CH group were 66 % and 66 % , respectively and for the control group 35 % and 20 % , respectively . The difference between the two groups was statistically significant ( p<0.01 ) at both 2 and 3 years . There was no difference in morbidity after surgery between these two groups , except a bowel ( colocutaneous ) fistula developed in two patients given MMC-CH . There were no operative deaths in this series . RésuméUne nouvelle méthode prophylactique et thérapeutique de la carcinose péritonéale , l'administration de la mitomycine C liée aux particules de carbone activé ( MMC-CH ) , a été testée chez les patients ayant un cancer gastrique au stade avancé dans une étude prospect i ve , r and omisée . Les particules de carbone activé sont absorbées sélectivement par le courant lymphatique qui semble être le premier site de l'atteinte carcinomateuse de la cavité péritonéale . Ceci permet la résorption d'une gr and e quantité de mitomycine C qui est ensuite relarguée lentement pendant une période de temps prolongé . Cent treize patients ayant eu une résection radicale pour cancer gastrique avec une atteinte séreuse sont rentrés dans cet essais . Ceux du groupe contrôle n'ont reçu aucune autre chimiothérapie . Les patients du groupe MMC-CH  ont reçu 50 mg de mitomycine C sous forme de MMC-CH , dispersée dans la cavité péritonéale juste avant la fermeture . Aucun autre médicament chimiothérapeutique a été administré à ces patients après la chimiothérapie intrapéritonéale : La survie à deux et à trois ans dans let groupe MMC-CH a été de 42 et de 38 pour-cent , respectivement , alors que les taux de survie du groupe contrôle étaient de 28 et de 20 pour-cent , respectivement . La différence de survie à 2 et à ans était statistiquement significantive ( p<0.05 ) . Chez les patients ayant une carcinose péritonéale macroscopique , les taux de survie ne présentaient aucune différence statistiquement significative entre les deux groupes . La survie à 2 et à 3 ans des patients ayant eu une résection histologiquement curative , étaient de 66 % et 66 % pour le groupe MMC-CH , et de 36 et de 20 pour-cent , respectivement . La différence entre les deux groupes était statistiquement significative ( p<0.01 ) à 2 et à 3 ans . II n'y avait aucune différence de morbidité après chirurgie dans les deux groupes excepté le développement de deux fistules intestinales ( colo-cutanée ) chez deux patients du group MMC-CH . II n'y avait aucune mortalité dans cette série . ResumenSe ensayó un novel método de profilaxis y tratamiento de la carinomatosis peritoneal , la mitomicina C ligada a partículas activadas de 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The second British Stomach Cancer Group trial was a prospect i ve r and omised controlled trial of adjuvant radiotherapy or cytotoxic chemotherapy after gastrectomy for adenocarcinoma . It recruited between 1981 and 1986 . No survival advantage has been demonstrated for the patients receiving either type of adjuvant therapy compared with those undergoing surgery alone . We report on 436 patients r and omised into the trial together with 203 patients , who did not fulfil the trial criteria , referred to the trial . A univariate ( log-rank ) analysis of pathological factors obtained from the local referring centres showed that tumour size , macroscopic type , number os sites involved , depth of invasion , involvement of resection lines and lymph nodes and histological grade were significant determinants of survival . Histological review by two experienced histopathologists found that the Lauren classification and histological grade , but not the Ming classification , were significant prognostic factors . The degree of lymphocytic and eosinophilic infiltration and presence of dysplasia assessed by one of the pathologists showed a significant correlation with survival . However , inter-observer correlation for these histological parameters and grade was poor . Multivariate analysis identified only depth of invasion , resection line and nodal involvement as significant independent pathological variables influencing survival . This study confirms the need for expert preparation of the resected specimen to obtain the important information on depth of invasion and nodal status and also reveals some variation in histological assessment , particularly grading , in gastric carcinoma OBJECTIVE To evaluate the effects of continuous hyperthermic peritoneal perfusion ( CHPP ) together with st and ard chemotherapy on the prognosis of patients with gastric cancer invading the serosa . DESIGN Retrospective study . SETTING University hospital , Japan . SUBJECTS 174 patients who had undergone curative resection for gastric cancer invading the serosa ( T3 ) between 1980 and 1989 , 78 of whom had been r and omised to be treated with CHPP after operation and 96 who received st and ard chemotherapy .  INTERVENTIONS CHPP was done immediately after operation ; 8 - 10 l fluid containing 80 - 100 mg/m2 mitomycin C was perfused at a rate of 100 - 200 ml/minute , and inflow and out flow temperatures were maintained at 44 - 45 degrees C and 40 - 42 degrees C , respectively . This was followed by a st and ard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil ( 1:4 ) ( UFT ) . The control group received the st and ard regimen only . MAIN OUTCOME MEASURES Five year survival and patterns of recurrence in three groups : no lymph node metastases , 1 - 9 , and 10 or more . RESULTS Only in the group with 1 - 9 lymph node metastases was there an appreciable but not significant difference in 5 year survival : 66 % compared with 44 % ( p = 0.084 ) . The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls . CONCLUSION CHPP improved prognosis in patients with T3 gastric cancer who had only 1 - 9 metastatic lymph nodes Background This r and omized phase III study was to evaluate the efficacy and safety of cytoreductive surgery ( CRS ) plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) for the treatment of peritoneal carcinomatosis ( PC ) from gastric cancer . Methods Sixty-eight gastric PC patients were r and omized into CRS alone ( n = 34 ) or CRS + HIPEC ( n = 34 ) receiving cisplatin 120 mg and mitomycin C 30 mg each in 6000 ml of normal saline at 43 ± 0.5 ° C for 60–90 min . The primary end point was overall survival , and the secondary end points were safety profiles . Results Major clinicopathological characteristics were balanced between the 2 groups . The PC index was 2–36 ( median 15 ) in the CRS + HIPEC and 3–23 ( median 15 ) in the CRS groups ( P = 0.489 ) . The completeness of CRS score ( CC 0–1 ) was 58.8 % ( 20 of 34 ) in the CRS and 58.8 % ( 20 of 34 ) in the CRS + HIPEC groups ( P = 1.000 ) . At a median follow-up of 32 months ( 7.5–83.5 months ) , death occurred in 33 of 34 ( 97.1 % ) cases in the CRS group and 29 of 34 ( 85.3 % ) cases of the CRS + HIPEC group . The median survival was 6.5 months ( 95 % confidence interval 4.8–8.2 months ) in CRS and 11.0 months ( 95 % confidence interval 10.0–11.9 months ) in the CRS + HIPEC groups ( P = 0.046 ) . Four patients ( 11.7 % ) in the CRS group and 5 ( 14.7 % ) patients in the CRS + HIPEC group developed serious adverse events ( P = 0.839 ) . Multivariate analysis found CRS + HIPEC , synchronous PC , CC 0–1 , systemic chemotherapy ≥ 6 cycles , and no serious adverse events were independent predictors for better survival . Conclusions For synchronous gastric PC , CRS + HIPEC with mitomycin C 30 mg and cisplatin 120 mg may improve survival with acceptable morbidity n= 16 ) ; intraoperative chemotherapy and UFT 300 mg/day ( P1 group , n= 13 ) ; or UFT 600 mg/day ( P2 group , n= 17 ) . Patients with an intestinal type of cancer were r and omly assigned to one of three treatment groups : H0 ( n= 17 ) , H1 ( n= 12 ) , and H2 ( n= 12 ) ; each group was subjected to the same protocol s as the P0 , P1 , and P2 groups , respectively , except for the MMC administration route . MMC ( 10 mg/patient ) was administered intraoperatively into the intraperitoneal cavity ( P1 and P2 groups ) or the portal vein ( H1 and H2 groups ) . All patients underwent curative resection . Background factors did not differ significantly among the treatment groups . The overall survival rates were progressively worsened in the order of P2 , P1 , and P0 or H2 , H1 , and H0 , respectively . The survival rate of the P2 group was statistically higher than that of the P0 group ( p < 0.05 ) . The intermediate-term survival rate of the P2 group or H2 group was significantly higher than that of the P0 group ( p < 0.05 ) or H0 group ( p < 0.05 ) , respectively . These results suggest the effectiveness of this therapy and the possible eradication of potential micrometastatic foci outside the surgical field by the direct administration of chemotherapeutic agents to the predicted recurrence site PURPOSE Previous studies have demonstrated a beneficial effect of intraperitoneally applied mitomycin bound to activated carbon particles ( M-CH ) in preventing intraabdominal recurrence following curative surgery for gastric cancer . The Austrian Working Group for Stomach Cancer , a subgroup of the Austrian Working Group for Surgical Oncology , initiated a multicentric phase III trial to evaluate the safety and efficacy of this treatment regimen . PATIENTS AND METHODS A total of 91 patients with a radically resected gastric cancer infiltrating the serosal surface were r and omly assigned to receive either 50 mg mitomycin bound to a solution of 375 mg carbo adsorbens intraperitoneally before closure of the abdominal wound ( n = 46 ) or served as a surgical control group ( n = 45 ) . Postoperative complications and recurrence-free and overall survival were evaluated to analyze the risks and benefits of this treatment . RESULTS After a median observation period of 597 days ( range , 72 to 1,096 ) , a significantly higher postoperative complication rate was observed in the M-CH group ( 35 % ) compared with the control group ( 16 % ) ( P < .02 ) . In accordance with this finding , the postoperative ( 60 days ) mortality rate was also significantly elevated in the M-CH group ( 11 % v 2 % in the control group ) . Since analysis of overall and recurrence-free survival failed to show any beneficial effect of M-CH therapy , the protocol committee decided to stop further recruitment of patients onto this study . CONCLUSION Adjuvant intraperitoneal therapy of gastric cancer by mitomycin bound to activated carbon particles is associated with an increased rate of postoperative complications . However , no benefit for prognosis following radical resection of locally advanced tumors was observed in this multicenter phase III trial A novel method of prophylaxis and treatment for peritoneal carcinomatosis — mitomycin C bound to activated carbon particles (MMC-CH)—was tested in patients with advanced gastric cancer in a prospect i ve r and omized study . Activated carbon particles are taken up selectively by lymphatic tissues , which seem to be a primary site of peritoneal carcinomatosis in the peritoneal cavity , and adsorb a large amount of anticancer agent mitomycin C , which is subsequently released slowly and for a protracted period . A group of 113 patients who underwent radical resection for gastric cancer with definite serosal involvement were entered in this trial . Those in the control group received no intraperitoneal anticancer drugs . Patients in the MMC-CH group were given 50 mg mitomycin C as MMC-CH , which was dispersed throughout the peritoneal cavity just before surgical closure . No other anticancer drugs were given to these patients after surgery . The 2- and 3-year survival rates for the MMC-CH group were 42 % and 38 % , respectively ; and the rates for the control group were 28 % and 20 % , respectively . The difference in survival between the two groups was significant at 2 and 3 years ( p<0.05 ) . For the survival of patients with macroscopic peritoneal carcinomatosis , there was no difference between these two groups . For the survival of patients who underwent histologically curative resection , 2- and 3-year survivals for the MMC-CH group were 66 % and 66 % , respectively and for the control group 35 % and 20 % , respectively . The difference between the two groups was statistically significant ( p<0.01 ) at both 2 and 3 years . There was no difference in morbidity after surgery between these two groups , except a bowel ( colocutaneous ) fistula developed in two patients given MMC-CH . There were no operative deaths in this series . RésuméUne nouvelle méthode prophylactique et thérapeutique de la carcinose péritonéale , l'administration de la mitomycine C liée aux particules de carbone activé ( MMC-CH ) , a été testée chez les patients ayant un cancer gastrique au stade avancé dans une étude prospect i ve , r and omisée . Les particules de carbone activé sont absorbées sélectivement par le courant lymphatique qui semble être le premier site de l'atteinte carcinomateuse de la cavité péritonéale . Ceci permet la résorption d'une gr and e quantité de mitomycine C qui est ensuite relarguée lentement pendant une période de temps prolongé . Cent treize patients ayant eu une résection radicale pour cancer gastrique avec une atteinte séreuse sont rentrés dans cet essais . Ceux du groupe contrôle n'ont reçu aucune autre chimiothérapie . Les patients du groupe MMC-CH  ont reçu 50 mg de mitomycine C sous forme de MMC-CH , dispersée dans la cavité péritonéale juste avant la fermeture . Aucun autre médicament chimiothérapeutique a été administré à ces patients après la chimiothérapie intrapéritonéale : La survie à deux et à trois ans dans let groupe MMC-CH a été de 42 et de 38 pour-cent , respectivement , alors que les taux de survie du groupe contrôle étaient de 28 et de 20 pour-cent , respectivement . La différence de survie à 2 et à ans était statistiquement significantive ( p<0.05 ) . Chez les patients ayant une carcinose péritonéale macroscopique , les taux de survie ne présentaient aucune différence statistiquement significative entre les deux groupes . La survie à 2 et à 3 ans des patients ayant eu une résection histologiquement curative , étaient de 66 % et 66 % pour le groupe MMC-CH , et de 36 et de 20 pour-cent , respectivement . La différence entre les deux groupes était statistiquement significative ( p<0.01 ) à 2 et à 3 ans . II n'y avait aucune différence de morbidité après chirurgie dans les deux groupes excepté le développement de deux fistules intestinales ( colo-cutanée ) chez deux patients du group MMC-CH . II n'y avait aucune mortalité dans cette série . ResumenSe ensayó un novel método de profilaxis y tratamiento de la carinomatosis peritoneal , la mitomicina C ligada a partículas activadas de 
    Output:
    