Aoyagi K*, Kizaki J, Isobe T, Minami T and Akagi Y
Department of Surgery, Kurume University School of Medicine, JapanFulltext PDF
Introduction: The prognosis is poor for patients with gastric cancer with positive cytologic examinations of peritoneal lavage fluid (CY1), and optimal treatment is not established. Further, the surgical strategy for patients with free cancer cells in the intraperitoneal fluid in the absence of overt peritoneal metastasis (CY1/P0) is controversial. Here, we investigated the clinical outcomes and prognostic factors of patients with CY1/P0 gastric cancer.Methods: We conducted an analysis of 39 patients with CY1/P0 gastric cancer who underwent gastrectomy and analyzed the clinical characteristics of patients who survived ≥3 years after surgery.Results: Large type-3 and type-4 tumors, scirrhous (sci), and infiltrative growth cancers (INFc) were associated with high recurrence rates. INFc was an independent risk factor for recurrence. Univariate analysis of overall survival (OS) showed that large type-3 and type-4 cancers, INFc, and lack of postoperative chemotherapy correlated with poor OS. Multivariate analysis showed that INFc and postoperative chemotherapy were independent prognostic factors. Univariate analysis showed that large type-3 and type-4 tumors, sci, INFc, and large tumor size correlated with poor progressionfree survival (PFS). Multivariate analysis showed that INFc was an independent prognostic factor of PFS. The numbers of long-term survivors with large type-3 and type-4 cancers were significantly lower compared with those with types 1–3.Conclusion: In patients with CY1/P0 gastric cancer, INF and postoperative chemotherapy were independent prognostic factors of OS. The prognosis of large type-3 and type-4 P0/CY1-gastric cancers is very poor. Therefore, such patients should be treated with multidisciplinary therapy such as neoadjuvant chemotherapy.
Aoyagi K, Kizaki J, Isobe T, Minami T, Akagi Y. Survival and Prognostic Factors of Patients with Advanced CY1/P0 Gastric Cancer. Clin Surg. 2016; 1: 1110.