Browse > Article
http://dx.doi.org/10.5230/jgc.2010.10.3.126

Prognostic Factors in Gastric Cancer Patients with Peritoneal Carcinomatosis  

Kim, Hyun-Il (Department of Surgery, College of Medicine, Hanyang University)
Ha, Tae-Kyung (Department of Surgery, College of Medicine, Hanyang University)
Kwon, Sung-Joon (Department of Surgery, College of Medicine, Hanyang University)
Publication Information
Journal of Gastric Cancer / v.10, no.3, 2010 , pp. 126-132 More about this Journal
Abstract
Purpose: Peritoneal carcinomatosis (PC) has a dismal prognosis and is occasionally encountered during initial exploration in patients with gastric cancer. The clinicopathological characteristics and survival were analyzed in patients with gastric cancer and PC. Materials and Methods: Among 2,083 gastric cancer patients who received surgery at the department of surgery, Hanyang University Hospital from 1992 to 2009, 130 patients revealed PC. Ten patients who were lost during follow-up were excluded. The remaining 120 patients were divided into three groups according to the type of surgery. The degree of PC was classified into P1(to the adjacent peritoneum) and P2 (to the distant peritoneum). Various other clinicopathological factors were analyzed using univariate and multivariatec survival analyses. Results: Systemic chemotherapy (SC), type of surgery, lymph node dissection, degree of PC, and presence of ascites were significant prognostic factors. However, age, gender, resection of PC, and Borrmann type were not significant prognostic factors. In a multivariate analysis, SC and the degree of PC were independent prognostic factors. The survival benefit of SC was significant without reference to the type of surgery or degree of PC. Conclusions: A gastrectomy should be considered feasible in patients with gastric cancer and PC. The independent favorable prognostic factors were SC and a low degree of PC. SC improved the prognosis regardless of operation type and degree of PC.
Keywords
Gastric cancer; Peritoneal carcinomatosis; Prognostic factor;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Fujimoto S, Takahashi M, Mutou T, Kobayashi K, Toyosawa T. Successful intraperitoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer 1999;85:529-534.   DOI   ScienceOn
2 Averabach AM, Jacquet P. Strategies to decrease the incidence of intra-abdominal recurrence in resectable gastric cancer. Br J Surg 1996;83:726-733.   DOI   ScienceOn
3 Yook JH, Oh ST, Kim BS. Clinicopathological analysis of Borrmann type IV gastric cancer. Cancer Res Treat 2005;37:87-91.   DOI   ScienceOn
4 Kikuchi S, Tsukamoto H, Mieno H, Sato K, Kobayashi N, Shimao H, et al. Results of resection of gastric cancer with distant metastases. Hepatogastroenterology 1998;45:592-596.
5 Kikuchi S, Arai Y, Morise M, Kobayashi N, Tsukamoto H, Shimao H, et al. Gastric cancer with metastases to the distant peritoneum: a 20-year surgical experience. Hepatogastroenterology 1998;45:1183-1188.
6 Sugarbaker PH, Yonemura Y. Clinical pathway for the management of resectable gastric cancer with peritoneal seeding: best palliation with a ray of hope for cure. Oncology 2000;58:96-107.   DOI   ScienceOn
7 Stern JL, Denman S, Elias EG, Didolkar M, Holyoke ED. Evaluation of palliative resection in advanced carcinoma of the stomach. Surgery 1975;77:291-298.
8 Kim JP, Kwon OJ, Oh ST, Yang HK. Results of surgery on 6589 gastric cancer patients and immunochemosurgery as the best treatment of advanced gastric cancer. Ann Surg 1992;216:269-278.   DOI   ScienceOn
9 Sugarbaker PH, Cunliff e W, Belliveau J, De Bruijn EA, Graves T, Mullins R, et al. Rationale for perioperative intraperitoneal chemotherapy as a surgical adjuvant for gastrointestinal malignancy. Reg Cancer Treat 1988;1:66-79.
10 Yun JH, Yang DH, Kang NP. Clinical significance of intraperitoneal free cancer cells in prognosis and treatment of gastric cancer. J Korean Surg Soc 1997;53:331-340.
11 Maekawa S, Saku M, Maehara Y, Sadanaga N, Ikejiri K, Anai H, et al. Surgical treatment for advanced gastric cancer. Hepatogatroenterology 1996;43:178-186.
12 Maehara Y, Morigiuchi S, Kakeji Y, Kohnoe S, Korenaga D, Haraguchi M, et al. Pertinent risk factors and gastric carcinoma with synchronous peritoneal dissemination or liver metastasis. Surgery 1991;110:820-823.
13 Kenkyukai I, ed. Japanese Classifi cation of Gastric Carcinoma. 1st ed. Tokyo: Kanehara & Co., 1995.
14 Kajitani T. The general rules for the gastric cancer study in surgery and pathology. Part I. Clinical classification. Jpn J Surg 1981;11:127-139.   DOI   ScienceOn
15 Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J, et al. Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study. Cancer 2000;88:358-363.   DOI   ScienceOn
16 Lee KK, Kwon SJ. Clinicopathological analysis of stage IV gastric cancer. J Korean Surg Soc 1999;56:369-377.
17 Kwon SJ. Results of surgical treatment for advanced gastric cancer analysis of prognostic factors. J Korean Surg Soc 1999;56(6 suppl):978-988.
18 Hyung WJ, Noh SH, Yoo CH, Huh JH, Shin DW, Lah KH, et al. Prognostic signifi cance of metastatic lymph node ratio in T3 gastric cancer. World J Surg 2002;26:323-329.   DOI   ScienceOn
19 Kim YJ, Kim BS, Choi WY, Yuk JH, Oh ST, Park KC. Prognostic significance of group 2 lymph node metastasis in pT3pN1 gastric cancer patients. J Korean Gastric Cancer Assoc 2004;4:32-35.   과학기술학회마을   DOI
20 Jang SW, Kim CH, Kim SW, Song SK. Prognostic factors and survival rates of stage III gastric cancer patients after a gastrectomy. J Korean Gastric Cancer Assoc 2004;4:137-142.   과학기술학회마을   DOI
21 Wisbeck WM, Becheer EM, Russell AH. Adenocarcinoma of the stomach: autopsy observations with therapeutic implications for the radiation oncologist. Radiother Oncol 1986;7:13-18.   DOI   ScienceOn
22 Noh SH, Yoo CH, Chung HC, Roh JK, Shin DW, Min JS. Early postoperative intraperitoneal chemotherapy with mitomycin C, 5-fluorouracil and cisplatin for advanced gastric cancer. Oncology 2001;60:24-30.   DOI   ScienceOn
23 Landry J, Tepper JE, Wood WC, Moulton EO, Koerner F, Sullinger J. Patterns of failure following curative resection of gastric carcinoma. Int J Rabiat Oncol Biol Phys 1990;19:1357-1362.   DOI   ScienceOn
24 Lawrence W Jr, McNeer G. The effectiveness of surgery for palliation of incurable gastric cancer. Cancer 1958;11:28-32.   DOI   ScienceOn
25 Gunderson LL, Sosin H. Adenocarcinoma of the stomach: areas of failure in a re-operation series (second or symptomatic look) clinicopathologic correlation and implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 1992;8:1-11.