Long-term results and prognostic factors of gastric cancer patients with only positive peritoneal lavage cytology

2011 ◽  
Vol 105 (4) ◽  
pp. 393-399 ◽  
Author(s):  
Cheong Ah Oh ◽  
Jae Moon Bae ◽  
Seung Jong Oh ◽  
Min Gew Choi ◽  
Jae Hyung Noh ◽  
...  
2017 ◽  
Vol 108 (5) ◽  
pp. 978-986 ◽  
Author(s):  
Eiji Higaki ◽  
Shinya Yanagi ◽  
Naoto Gotohda ◽  
Takahiro Kinoshita ◽  
Takeshi Kuwata ◽  
...  

2018 ◽  
Vol 36 (4) ◽  
pp. 331-339
Author(s):  
Alberto Biondi ◽  
Domenico D’Ugo ◽  
Ferdinando Cananzi ◽  
Stefano Rausei ◽  
Federico Sicoli ◽  
...  

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors. Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guang-Chuan Mu ◽  
Yuan Huang ◽  
Zhi-Ming Liu ◽  
Xiang-Hua Wu ◽  
Xin-Gan Qin ◽  
...  

Abstract Background The aim of this study was to explore the prognostic factors and establish a nomogram to predict the long-term survival of gastric cancer patients. Methods The clinicopathological data of 421 gastric cancer patients, who were treated with radical D2 lymphadenectomy by the same surgical team between January 2009 and March 2017, were collected. The analysis of long-term survival was performed using Cox regression analysis. Based on the multivariate analysis results, a prognostic nomogram was formulated to predict the 5-year survival rate probability. Results In the present study, the total overall 3-year and 5-year survival rates were 58.7 and 45.8%, respectively. The results of the univariate Cox regression analysis revealed that tumor staging, tumor location, Borrmann type, the number of lymph nodes dissected, the number of lymph node metastases, positive lymph nodes ratio, lymphocyte count, serum albumin, CEA, CA153, CA199, BMI, tumor size, nerve invasion, and vascular invasion were prognostic factors for gastric cancer (all, P < 0.05). However, merely tumor staging, tumor location, positive lymph node ratio, CA199, BMI, tumor size, nerve invasion, and vascular invasion were independent risk factors, based on the results of the multivariate Cox regression analysis (all, P < 0.05). The nomogram based on eight independent prognostic factors revealed a well-degree of differentiation with a concordance index of 0.76 (95% CI: 0.72–0.79, P < 0.001), which was better than the AJCC-7 staging system (concordance index = 0.68). Conclusion The present study established a nomogram based on eight independent prognostic factors to predict long-term survival in gastric cancer patients. The nomogram would be beneficial for more accurately predicting the prognosis of gastric cancer, and provide important basis for making individualized treatment plans following surgery.


2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 134-134
Author(s):  
Katarzyna Marcisz-Grzanka ◽  
Paulina Wieszczy ◽  
Malgorzata Malinowska ◽  
Lucjan Wyrwicz ◽  
Tomasz Olesiński

134 Background: The prognosis in gastric cancer is highly dependent on tumor stage at presentation. Surgery still remains the main therapeutic option in gastric cancer patients. However, the efficacy of this treatment may be substantially limited by the risk of peritoneal dissemination. The introduction of intraperitoneal chemotherapy (HIPEC) may affect the long-term outcomes in this group of patients, but high morbidity associated with such treatment provides the rational to identify the correct population of patients for HIPEC. Methods: This is the long-term effect analysis of prospectively observed cohort of patients assessed with immunocytochemistry peritoneal lavage in the single reffereal center. Between January 2002 and November 2004, the total of 140 patients with histologically confirmed gastric cancer were enrolled to the study. Laparotomy and intraoperative peritoneal lavage for immunocytochemistry examination were performed prior to gastrectomy. The fluid recovered was centrifuged and the sediment was fixed in 10% buffered formalin for 24 h, embedded in paraffin and cut into 4 µm-thick sections. Microscopic slides were also stained against cytokeratin 19 (CK-19), cytokeratin AE1/AE3 (CK-AE1/AE3) and mesothelioma marker. All patients were followed up with endpoints of cancer recurrence and mortality. Results: Median overall survival (OS) in patients with immunocytochemical evidence of free cancer cells in peritoneal washes was significantly shorter than in those without (11 [range: 2-55] vs. 45 [range: 1-164] months). The two groups differed significantly in long-term survival (5-year OS rate: 0.0% [0/17] vs. 43.1% [53/123]; 10-year OS rate: 0.0% [0/17] vs. 29.3% [36/123]) (p < 0.001). Positive peritoneal washing immunocytochemistry was an independent poor outcome prognostic factor after correction for all major prognostic factors. Conclusions: Positive peritoneal washing immunocytochemistry correlated with clinical staging of gastric cancer and was associated with poor overall survival (OS). With all patients dying in 5 years, this subgroup of patients defines a clear population for early salvage HIPEC for prospective verification.


2010 ◽  
Vol 14 (12) ◽  
pp. 1917-1922 ◽  
Author(s):  
Hun Jung ◽  
Hae Myung Jeon ◽  
Han Hong Lee ◽  
Kyo Young Song ◽  
Cho Hyun Park

Author(s):  
Fezzeh Elyasinia ◽  
Faramarz Karimian ◽  
Fatemeh Samiei ◽  
Ehsan Sadeghian

Background: Imaging, cytological examination of ascites (if present), laparosco- py, and peritoneal lavage are performed before surgery for gastric cancer staging. Peritoneal lavage aims to diagnose the microscopic presence of tumor cells on the peritoneal surface. Positive cytology may have a prognostic value that classifies the disorder as stage IV, in which the patient is no longer an elective surgical candidate. Thus, our study was designed to assess the ability of peritoneal lavage to stage gastric cancer in non-ascitic patients based on cytological evaluation and carcinoembryonic antigen (CEA) level measurement. Methods: In our prospective study, we examined gastric cancer patients who were candidates for elective surgery. Upon entering the abdominal cavity and before tu- mor manipulation, normal saline (500 ml) was applied, and the abdominal cavity was thoroughly dispersed. After three minutes, the fluid was drained and addressed to cytological analysis and CEA measurement by radioimmunoassay (RIA). Study var- iables including age, sex, family history, tumor position, pathology, staging, grading, the original tumor size, regional lymph node involvement, and distant metastases were recorded during the pre- and postoperative staging. The association between positive peritoneal lavage cytology and various patients’ characteristics was investigated. Results: In this study, 94 patients were screened. Due to lymphoma and gastrointes- tinal stromal tumor (GIST), two patients were excluded. We examined 92 patients, including 63 males (68.5 %) and 29 females (31.5 %). The mean age of patients was 58.52 ± 11.87 years. The most common tumor location was the esophagogastric junction. Moderately differentiated adenocarcinoma was the most frequent micro- scopic diagnosis. T3 was the most prevalent primary tumor size in 51 patients. Sev- enty-two patients (78.26%) were operable, of whom 18 (19.6 %) were positive for peritoneal lavage cytology. Positive cytology of peritoneal lavage was significantly related to tumor size, tumor grade, serosa/adjacent organ invasion (T4), laparoscopic staging findings, locally advanced disease (R0), and stage of the disease (P < 0.05). In the peritoneal lavage fluid, elevated CEA titers were significantly related to the high-grade tumor (P = 0.012).  Conclusion: Our study demonstrated that positive cytology and high CEA titers in peritoneal lavage fluid of gastric cancer patients without ascites are significantly correlated to the advanced stages.  


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