Hironori Shiozaki1, Elena Elimova1, Rebecca S Slack2, Hsiang-Chun Chen2, Gregg A Staerkel3, Nour Sneige3, Yusuke Shimodaira1, Tara Sagebiel4, Jeffrey H Lee5, Manoop S Bhutani5, Prajnan Das6, Paul F Mansfield7, Jeannelyn S Estrella3, Brian D Badgwell7, Jaffer A Ajani1. 1. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 6. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 7. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Peritoneal metastases (PM) in patients with gastric adenocarcinoma (GAC) may be identified by diagnostic laparoscopy (DL) or imaging (I). Although prognosis is poor, some patients have excellent outcome. We compared the overall survival (OS) of patients in 3 groups: those with positive cytology (CY+) by DL (DL-CY+), those with gross PM (GPM) by DL (DL-GPM+) and with GPM obvious on I (I-GPM+). METHODS: 146 GAC patients were identified. The Kaplan-Meier analysis, univariate, and multivariate Cox proportional hazards regression models were employed. RESULTS: Patients were primarily men (67%), with good ECOG scores (0-1; 89%), had DL (84%), had poorly differentiated GAC (92%), and had received chemotherapy (89%). The median OS for all patients was 15 months (5% CI, 12.9-18.2 months). The DL-CY+ group had median OS of 22.5 months (95% CI, 15-29.3 months). Patients with I-GPM+ had four times the risk of death than those with DL-CY+ (P < 0.001) and patients with DL-GPM+ had two times the risk of death than those with DL-CY+ (P = 0.001). At 36 months, all DL-GPM+ and I-GPM+ had died but 8 patients with DL-CY+ remained alive. CONCLUSIONS: Some GAC patients with DL-CY+ have long OS; therefore, novel strategies to further prolong their OS are needed.
BACKGROUND: Peritoneal metastases (PM) in patients with gastric adenocarcinoma (GAC) may be identified by diagnostic laparoscopy (DL) or imaging (I). Although prognosis is poor, some patients have excellent outcome. We compared the overall survival (OS) of patients in 3 groups: those with positive cytology (CY+) by DL (DL-CY+), those with gross PM (GPM) by DL (DL-GPM+) and with GPM obvious on I (I-GPM+). METHODS: 146 GAC patients were identified. The Kaplan-Meier analysis, univariate, and multivariate Cox proportional hazards regression models were employed. RESULTS:Patients were primarily men (67%), with good ECOG scores (0-1; 89%), had DL (84%), had poorly differentiated GAC (92%), and had received chemotherapy (89%). The median OS for all patients was 15 months (5% CI, 12.9-18.2 months). The DL-CY+ group had median OS of 22.5 months (95% CI, 15-29.3 months). Patients with I-GPM+ had four times the risk of death than those with DL-CY+ (P < 0.001) and patients with DL-GPM+ had two times the risk of death than those with DL-CY+ (P = 0.001). At 36 months, all DL-GPM+ and I-GPM+ had died but 8 patients with DL-CY+ remained alive. CONCLUSIONS: Some GAC patients with DL-CY+ have long OS; therefore, novel strategies to further prolong their OS are needed.
Authors: Dilsa Mizrak Kaya; Graciela M Nogueras-González; Kazuto Harada; Fatemeh G Amlashi; Sinchita Roy-Chowdhuri; Jeannelyn S Estrella; Prajnan Das; Jeffrey H Lee; Brian Weston; Manoop S Bhutani; Aurelio Matamoros; Irene Thomas; Quan Lin; Brian D Badgwell; Jaffer A Ajani Journal: J Surg Oncol Date: 2017-12-04 Impact factor: 3.454
Authors: Casey J Allen; Alisa N Blumenthaler; Prajnan Das; Bruce D Minsky; Mariela Blum; Sinchita Roy-Chowdhuri; Jaffer A Ajani; Naruhiko Ikoma; Paul F Mansfield; Brian D Badgwell Journal: World J Surg Oncol Date: 2020-02-17 Impact factor: 2.754