ArticleWorld journal of surgical oncology2023
Efficacy of chemotherapy versus surgery as initial treatment for gastric cancer with positive peritoneal cytology.
Article in World journal of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The Clinical Value of Laparoscopic Exploration in Diagnosing and Dynamically Assessing Occult Peritoneal Metastasis in Gastric 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
- Prognostic Impact of Hyperthermic Intraperitoneal Chemotherapy After Laparoscopic Gastrectomy in Gastric Cancer with Positive Peritoneal Lavage Cytology and no Other Noncurative Factors.Annals of surgical oncology · 2026Article
- Staging laparoscopy for gastric cancer: European consensus.The British journal of surgery · 2025Article
- Emerging Trends in the Management of Gastric Malignancy with Peritoneal Dissemination: Same Disease, Heterogeneous Prognosis.Cancers · 2025Review
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Authors and funding
12 authors.
Funding
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Abstract
backgroundThe prognosis of gastric cancer (GC) patients with positive peritoneal cytology (CY1) without other distant metastasis is poor, and there are no standard treatment strategies. Our study aimed to compare the survival outcomes of CY1 GC patients receiving chemotherapy or surgery as initial treatment.
methodsFrom February 2017 to January 2020, clinical and pathological data of patients diagnosed with CY1 GC without other distant metastasis in the Peking University Cancer Hospital was reviewed. Patients were divided into two groups: chemotherapy-initial group and surgery-initial group. In chemotherapy-initial group, patients received preoperative chemotherapy initially. According to the treatment response, the patients were divided into three subgroups: conversion gastrectomy group, palliative gastrectomy group, and further systematic chemotherapy group. In surgery-initial group, patients underwent gastrectomy followed by postoperative chemotherapy.
resultsA total of 96 CY1 GC patients were included with 48 patients in each group. In chemotherapy-initial group, preoperative chemotherapy yielded an objective response rate of 20.8% and disease control rate of 87.5%. Conversion to CY0 after preoperative chemotherapy was obtained in 24 (50%) patients. The median overall survival was 36.1 months in chemotherapy-initial group and 29.7 months in surgery-initial group (p = 0.367). The median progression-free survival was 18.1 months in chemotherapy-initial group and 16.1 months in surgery-initial group (p = 0.861). The 3-year overall survival rates were 50.0% and 47.9%, respectively. In chemotherapy-initial group, twenty-four patients who converted to CY0 by preoperative chemotherapy and received surgery obtained a significantly better prognosis. The median overall survival was still not reached in these patients.
conclusionThere was no significant difference in survival outcomes between chemotherapy-initial group and surgery-initial group. CY1 GC patients who converted to CY0 by preoperative chemotherapy and received radical surgery could obtain a favorable long-term prognosis. Further investigation should focus on preoperative chemotherapy to eliminate peritoneal cancer cell.
trial registrationThis study is retrospectively registered.
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