Premium
Risk of peritoneal metastases in patients who had negative peritoneal staging and received therapy for localized gastric adenocarcinoma
Author(s) -
Mizrak Kaya Dilsa,
NoguerasGonzález Graciela M.,
Harada Kazuto,
Amlashi Fatemeh G.,
RoyChowdhuri Sinchita,
Estrella Jeannelyn S.,
Das Prajnan,
Lee Jeffrey H.,
Weston Brian,
Bhutani Manoop S.,
Matamoros Aurelio,
Thomas Irene,
Lin Quan,
Badgwell Brian D.,
Ajani Jaffer A.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24912
Subject(s) - medicine , peritoneal carcinomatosis , adenocarcinoma , multivariate analysis , gastric adenocarcinoma , gastroenterology , surgery , cancer , colorectal cancer
Background Positive peritoneal cytology (+PCyt) or gross carcinomatosis (GPC) carries a poor prognosis. Laparoscopic staging to detect +PCyt/GPC is recommended for all ≥T1b gastric adenocarcinoma (GAC). The natural history of patients with GAC who have baseline −PCyt and then undergo multimodality therapy is not well documented, particularly for the risk of subsequent GPC. Methods We identified 238 GAC patients with baseline −PCyt who were followed for the development of peritoneal carcinomatosis (PC). Standard statistical methods were employed. Results Of 238 patients, 192 had attempted surgery after preoperative therapy. Of these, 13 patients (6.8%) had GPC and one had liver metastases, thus surgery was aborted. We followed 164 patients who had an R0 resection. The median follow‐up duration was 3.4 (range, 0.6‐18) years. The rate of PC was 13.4%, (22/164 patients) and the median time to PC was 15.6 months. Female gender was associated with PC on multivariate analysis. The 5‐year OS rate for patients without subsequent PC was 75%. Conclusion Even with baseline −Cyt, ∼25% of patients develop PC following multimodality therapy. Patients who do not develop PC have an excellent OS rate. Further research is warranted to detect PC at baseline by the use of biomarkers.