ArticleWorld journal of surgical oncology2021
Gastric cancer with positive peritoneal cytology: survival benefit after induction chemotherapy and conversion to negative peritoneal cytology.
Article in World journal of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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26 citing papers in PubMed, 42 citations in OpenAlex.
- Long-Term Outcomes of Patients with Gastric Cancer and Positive Peritoneal Cytology.Annals of surgical oncology · 2026Article
- Catalytic profiling of extracellular vesicles maps altered cancer metabolism.Nature nanotechnology · 2026Article
- Letter to Editor of Annals of Surgical Oncology Concerning "The Impact of Diagnostic Laparoscopy on Upstaging Patients with Siewert II and III Gastroesophageal Junction (GEJ) Cancer".Annals of surgical oncology · 2026Article
- The Role of HIPEC in Isolated Cytology-Positive Gastric Cancer: Nodal Metastasis Dominates Prognosis, HIPEC Remains Unproven.Annals of surgical oncology · 2026Article
- Advances and challenges in the application of prophylactic hyperthermic intraperitoneal chemotherapy for gastric cancer.Frontiers in oncology · 2026Review
- Current Challenges and Future Directions in the Multimodal Management of Gastric Cancer with Peritoneal Metastases.Cancers · 2025Article
- Article
- Review
- Preoperative assessment and prognostic prediction of gastric cancer patients with peritoneal metastasis usingEJNMMI research · 2025Article
- Emerging Trends in the Management of Gastric Malignancy with Peritoneal Dissemination: Same Disease, Heterogeneous Prognosis.Cancers · 2025Review
- Time to Discard the Staging Laparoscopy? Elucidating the Role for Routine Diagnostic Laparoscopy in Patients with Gastroesophageal Junction Malignancy.Annals of surgical oncology · 2025Article
- Review
- The Advancement Stage of Gastric Cancer and the Levels of CEA and Ca19-9 in Serum and Peritoneal Lavage.Biomedicines · 2024Article
- Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging.Journal of Zhejiang University. Science. B · 2024Article
- Article
- A preoperative predictive tool to assess the need for staging laparoscopy in oesophagogastric cancer patients.Annals of the Royal College of Surgeons of England · 2024Article
- Predicting Peritoneal Carcinomatosis in Locally Advanced Gastric Cancer: The Significance of Tumor Markers in the Peritoneal Washing.Journal of gastrointestinal cancer · 2024Article
- Article
- Efficacy of chemotherapy versus surgery as initial treatment for gastric cancer with positive peritoneal cytology.World journal of surgical oncology · 2023Article
- Prognostic Impact of Positive Peritoneal Lavage Cytology on Resectable Pancreatic Body and Tail Cancer: A Retrospective Study.World journal of surgery · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal treatment in patients with gastric cancer and peritoneal disease remains controversial. Some guidelines indicate palliative treatment only, while others consider surgical treatment in case of positive lavage cytology (CY+) or limited peritoneal disease. Here, we analyzed the role of peritoneal disease in patients with gastric cancer, and the prognostic relevance of response to neoadjuvant therapy.
methodsIn this retrospective cohort analysis, we analyzed patients with adenocarcinoma of the stomach or esophago-gastric junction from a single center operated between 2011 and 2019. According to histology and lavage cytology, patients were classified into four risk groups: (A) no peritoneal disease, (B) CY+ who converted to negative lavage cytology (CY-) after neoadjuvant chemotherapy, (C) CY+ without conversion after chemotherapy, and (D) patients with visible peritoneal metastasis.
resultsOverall, n = 172 patients were included. At initial presentation, n = 125 (73%) had no peritoneal disease, and about a third of patients (n = 47, 27%) had microscopic or macroscopic peritoneal disease. Among them, n = 14 (8%) were CY+ without visible peritoneal metastasis, n = 9 converted to CY- after chemotherapy, and in n = 5 no conversion was observed. Median overall survival was not reached in patients who had initially no peritoneal disease and in patients who converted after chemotherapy, resulting in 3-year survival rates of 65% and 53%. In contrast, median overall survival was reduced to 13 months (95% CI 8.7-16.7) in patients without conversion and was 16 months (95% CI 12-20.5) in patients with peritoneal metastasis without difference between the two groups (p = .364). The conversion rate from CY+ to CY- was significantly higher after neoadjuvant treatment with FLOT (5-fluorouracil plus leucovorin, oxaliplatin, and docetaxel) compared to ECF (epirubicin, cisplatin, and 5-fluorouracil) (p = 0.027).
conclusionConversion of CY+ to CY- after neoadjuvant chemotherapy with FLOT is a significant prognostic factor for a better overall survival. Surgical treatment in well-selected patients should therefore be considered. However, peritoneal recurrence remains frequent despite conversion, urging for a better local control.
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