K Yamashita1, H Ushiku2, N Katada2, K Hosoda2, H Moriya2, H Mieno2, S Kikuchi2, K Hoshi3, M Watanabe2. 1. Department of Surgery, Kitasato University School of Medicine, Japan. Electronic address: keishi23@med.kitasato-u.ac.jp. 2. Department of Surgery, Kitasato University School of Medicine, Japan. 3. Department of Hygiene, Kitasato University School of Medicine, Japan.
Abstract
BACKGROUND: Peritoneal lavage cytology cancer-positive (CY1) is a critical prognostic factor and is taken as representing stage IV in gastric cancer. There is no consensus treatment strategy for CY1-gastric cancer, and the detailed clinicopathological features remain obscure. PATIENTS AND METHODS: Among 790 gastric cancer patients between 2005 and 2009, 52 cases of CY1 were identified (6.6%). A multivariate prognostic model was applied to the univariate prognostic factors to identify independent prognostic factors and factors associated with long-term survival in CY1-gastric cancer. RESULTS: (1) Five-year overall survival (OS) was 17.6% in CY1-gastric cancer as compared with 93.9% in CYX and 77.7% in CY0 (77.7%), where tumors with pT2 or beyond were included in 11% of CYX, 73% of CY0, and 98% of CY1 cases. (2) On univariate analysis, factors associated with a negative prognosis were the presence of peritoneal dissemination (p = 0.029) and high preoperative serum albumin (p = 0.011) in CY1-gastric cancer. The multivariate Cox proportional hazards and logistic regression model using propensity score identified preoperative albumin as a critical independent prognostic indicator. (3) Long-term survivors were identified and, were often characterized by long-term postoperative adjuvant treatment. CONCLUSION: Reduced preoperative serum albumin and absence of peritoneal dissemination may be predictive factors for long-term survival in patients with advanced gastric cancer with positive cytology test. Long-term postoperative adjuvant therapy might improve survival of patients with CY1.
BACKGROUND: Peritoneal lavage cytology cancer-positive (CY1) is a critical prognostic factor and is taken as representing stage IV in gastric cancer. There is no consensus treatment strategy for CY1-gastric cancer, and the detailed clinicopathological features remain obscure. PATIENTS AND METHODS: Among 790 gastric cancerpatients between 2005 and 2009, 52 cases of CY1 were identified (6.6%). A multivariate prognostic model was applied to the univariate prognostic factors to identify independent prognostic factors and factors associated with long-term survival in CY1-gastric cancer. RESULTS: (1) Five-year overall survival (OS) was 17.6% in CY1-gastric cancer as compared with 93.9% in CYX and 77.7% in CY0 (77.7%), where tumors with pT2 or beyond were included in 11% of CYX, 73% of CY0, and 98% of CY1 cases. (2) On univariate analysis, factors associated with a negative prognosis were the presence of peritoneal dissemination (p = 0.029) and high preoperative serum albumin (p = 0.011) in CY1-gastric cancer. The multivariate Cox proportional hazards and logistic regression model using propensity score identified preoperative albumin as a critical independent prognostic indicator. (3) Long-term survivors were identified and, were often characterized by long-term postoperative adjuvant treatment. CONCLUSION: Reduced preoperative serum albumin and absence of peritoneal dissemination may be predictive factors for long-term survival in patients with advanced gastric cancer with positive cytology test. Long-term postoperative adjuvant therapy might improve survival of patients with CY1.
Authors: Elena Ongaro; Vanessa Buoro; Marika Cinausero; Riccardo Caccialanza; Annalisa Turri; Valentina Fanotto; Debora Basile; Maria Grazia Vitale; Paola Ermacora; Giovanni Gerardo Cardellino; Laura Nicoletti; Lorenzo Fornaro; Andrea Casadei-Gardini; Giuseppe Aprile Journal: Gastric Cancer Date: 2017-05-05 Impact factor: 7.370
Authors: Zhuoyu Yang; Yadi Zheng; Zheng Wu; Yan Wen; Gang Wang; Shuohua Chen; Fengwei Tan; Jiang Li; Shouling Wu; Min Dai; Ni Li; Jie He Journal: Cancer Med Date: 2021-05-26 Impact factor: 4.452