A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

There is lack of uniformity in the utilization of peritoneal cytology in gastric cancer management. The identification of intraperitoneal free cancer cells (IFCCs) is believed to confer poor prognosis. However, while some of these patients are palliated, others may undergo more aggressive therapies. In this review, we aimed to identify and synthesize findings on the use of peritoneal cytology in predicting peritoneal recurrence and overall survival in curative gastric cancer patients.

Related collections

Most cited references 36

Record: found
Abstract: not found
Article: not found

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

A Okines, M Verheij, W Allum … (2010)

0 comments Cited 81 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Extensive intraoperative peritoneal lavage as a standard prophylactic strategy for peritoneal recurrence in patients with gastric carcinoma.

Hideo Baba, Satosi Ikeshima, Akinobu Matsuo … (2009)

This prospective randomized multicenter study aims to evaluate the efficacy of extensive intraoperative peritoneal lavage followed by intraperitoneal chemotherapy (EIPL-IPC) on the overall 5-year survival of advanced gastric cancer patients with intraperitoneal free cancer cells without overt peritoneal metastasis (CY+/P-). The study also aims to determine the merit and reliability of EIPL-IPC therapy as a prophylactic strategy for peritoneal metastasis. Although the prognosis of advanced gastric cancer patients with CY+/P- is extremely poor, a suitable standard regimen for treating such patients has not yet been established. A total of 88 patients with CY+/P- from 1522 patients with advanced gastric cancer at multicenters were enrolled in this study and were randomly allocated to 3 groups: surgery alone group, surgery plus intraperitoneal chemotherapy (IPC) group, and surgery plus EIPL and IPC (EIPL-IPC) group. Prognostic significance of EIPL-IPC therapy was evaluated by Kaplan-Meier curves, and its value as an independent prognostic factor was assessed by univariate and multivariate analyses. The overall 5-year survival rate of the patients with EIPL-IPC was 43.8%, and this data were significantly better than that of the IPC group (4.6%, P < 0.0001) and the surgery alone group (0%, P < 0.0001). Among various recurrent patterns, the EIPL-IPC group had a significantly lower incidence of peritoneal recurrence than both of the other groups (P < 0.0001). Univariate and multivariate analyses revealed that EIPL was the most significant impact factor. The present study clearly revealed that EIPL-IPC therapy significantly improved the 5-year survival span of advanced gastric cancer patients with CY+/P-. Thus, EIPL-IPC therapy is strongly recommended as a standard prophylactic strategy for peritoneal dissemination.

0 comments Cited 60 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The value of peritoneal cytology as a preoperative predictor in patients with gastric carcinoma undergoing a curative resection.

Madhu Mazumdar, David J. Bentrem, Daniel G. Coit … (2005)

Although positive peritoneal cytology is associated with poor prognosis, it has not been found to be independently predictive of outcome when evaluated in context of post-resection pathologic T and N stage. This study was undertaken to evaluate the predictive value of positive cytology in context of other prognostic factors available prior to surgery in patients undergoing R0 resection for gastric cancer, to assess its role in selecting patients for appropriate treatment prior to surgical resection. Clinical variables for all patients undergoing R0 resection for gastric adenocarcinoma at Memorial Sloan-Kettering Cancer Center from 1993-2002 were reviewed from a prospective database. Patients underwent preoperative assessment of T and N stage with CT scan, laparoscopy, and endoscopic and/or laparoscopic ultrasound. Peritoneal cytology was obtained in all patients. Patients with gastric cancer (n = 371) underwent R0 resection and staging laparoscopy with peritoneal washings; 24 patients (6.5%) had positive peritoneal cytology. Positive cytology was associated with advanced T stage (P = 0.02) but not with nodal positivity (P = 0.11). Median survival of patients with positive cytology was 14.8 months vs. 98.5 months for patients with negative cytology (P < 0.001). Multivariate analysis identified preoperative T stage, preoperative N stage, site, and cytology as significant predictors of outcome. Positive cytology was the preoperative factor most predictive of death from gastric cancer (RR 2.7, P < 0.001). Positive cytology is information potentially available preoperatively that identifies a patient population at very high risk for early recurrence and death after curative resection of gastric cancer.