Top

Published in:

01-03-2010

Significance of Lavage Cytology in Advanced Gastric Cancer Patients

Authors: Takeo Fukagawa, Hitoshi Katai, Makoto Saka, Shinji Morita, Yuko Sasajima, Hirokazu Taniguchi, Takeshi Sano, Mitsuru Sasako

Published in: World Journal of Surgery | Issue 3/2010

Abstract

Background

Lavage cytology positive (Cy1) is well known as a poor prognostic factor in advanced gastric cancer patients. However, the optimal therapeutic strategy for patients with Cy1 has not yet been established. The aim of this study was to evaluate the clinical significance of Cy1 for the purpose of establishing a suitable therapeutic strategy.

Methods

The data of 996 consecutive advanced gastric cancer patients who underwent gastrectomy between 1992 and 1998 at the National Cancer Center Hospital were retrospectively studied.

Results

The 2- and 5-year survival rates of the patients who underwent gastrectomy without any other noncurative factors besides Cy1 were 25.3 and 7.8%, respectively. When the analysis was limited to type 4 advanced gastric cancer patients, none of the patients with Cy1 survived for more than 40 months.

Conclusions

The prognosis of gastric cancer patients with Cy1 is very poor. Some patients show long survival after standard gastrectomy with D2 lymph node dissection; however, the prognosis of type 4 gastric cancer patients with Cy1 is so poor that multimodality therapy, including perioperative chemotherapy, is essential.

Sasako M, Sano T, Yamamoto S et al (2008) D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med 359(5):453–462CrossRefPubMed

Sasako M, Sano T, Yamamoto S et al (2006) Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol 7(8):644–651CrossRefPubMed

Sakuramoto S, Sasako M, Yamaguchi T et al (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357(18):1810–1820CrossRefPubMed

Sano T, Sasako M, Kinoshita T, Maruyama K (1993) Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer 72(11):3174–3178CrossRefPubMed

Gotoda T (2007) Endoscopic resection of early gastric cancer. Gastric Cancer 10(1):1–11CrossRefPubMed

Oda I, Saito D, Tada M et al (2006) A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer 9(4):262–270CrossRefPubMed

Morita S, Katai H, Saka M et al (2008) Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg 95(9):1131–1135CrossRefPubMed

Kitano S, Shiraishi N, Uyama I et al (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245(1):68–72CrossRefPubMed

Burke EC, Karpeh MS Jr, Conlon KC et al (1998) Peritoneal lavage cytology in gastric cancer: an independent predictor of outcome. Ann Surg Oncol 5(5):411–415CrossRefPubMed

10.

Nath J, Moorthy K, Taniere P et al (2008) Peritoneal lavage cytology in patients with oesophagogastric adenocarcinoma. Br J Surg 95(6):721–726CrossRefPubMed

11.

Ribeiro U Jr, Safatle-Ribeiro AV, Zilberstein B et al (2006) Does the intraoperative peritoneal lavage cytology add prognostic information in patients with potentially curative gastric resection? J Gastrointest Surg 10(2):170–176 discussion 176-177CrossRefPubMed

12.

Hayes N, Wayman J, Wadehra V et al (1999) Peritoneal cytology in the surgical evaluation of gastric carcinoma. Br J Cancer 79(3–4):520–524CrossRefPubMed

13.

Bentrem D, Wilton A, Mazumdar M et al (2005) The value of peritoneal cytology as a preoperative predictor in patients with gastric carcinoma undergoing a curative resection. Ann Surg Oncol 12(5):347–353CrossRefPubMed

14.

Kodera Y, Nakanishi H, Ito S et al (2004) Detection of disseminated cancer cells in linitis plastica-type gastric carcinoma. Jpn J Clin Oncol 34(9):525–531CrossRefPubMed

15.

Bando E, Kawamura T, Kinoshita K et al (2003) Magnitude of serosal changes predicts peritoneal recurrence of gastric cancer. J Am Coll Surg 197(2):212–222CrossRefPubMed

16.

Yonemura Y, Kawamura T, Bandou E et al (2007) The natural history of free cancer cells in the peritoneal cavity. Recent Results Cancer Res 169:11–23PubMed

17.

Rosenberg R, Nekarda H, Bauer P et al (2006) Free peritoneal tumour cells are an independent prognostic factor in curatively resected stage IB gastric carcinoma. Br J Surg 93(3):325–331CrossRefPubMed

18.

Fujitani K, Yang HK, Kurokawa Y et al (2008) Randomized controlled trial comparing gastrectomy plus chemotherapy with chemotherapy alone in advanced gastric cancer with a single non-curable factor: Japan clinical oncology group study JCOG 0705 and Korea gastric cancer association study KGCA01. Jpn J Clin Oncol 38(7):504–506CrossRefPubMed

19.

Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma, 2nd English edn. Gastric Cancer 1(1):10–24CrossRefPubMed

20.

Miyashiro I, Takachi K, Doki Y et al (2005) When is curative gastrectomy justified for gastric cancer with positive peritoneal lavage cytology but negative macroscopic peritoneal implant? World J Surg 29(9):1131–1134CrossRefPubMed

21.

Kodera Y, Ito S, Mochizuki Y et al (2009) A phase II study of radical surgery followed by postoperative chemotherapy with S-1 for gastric carcinoma with free cancer cells in the peritoneal cavity (CCOG0301 study). Eur J Surg Oncol 35(11):1158–1163PubMed

22.

Sano T (2007) We have entered a new era of adjuvant/neoadjuvant therapy for gastric cancer. Gastrointest Cancer Res 1(4):156–157PubMed

23.

Ako E, Ohira M, Yamashita Y et al (2008) Efficacy of S-1 for gastric cancer patients with positive peritoneal lavage cytology. Hepatogastroenterology 55(86–87):1939–1942PubMed

24.

Kinoshita T, Sasako M, Sano T et al (2009) Phase II trial of S-1 for neoadjuvant chemotherapy against scirrhous gastric cancer (JCOG 0002). Gastric Cancer 12(1):37–42CrossRefPubMed

25.

Feussner H, Omote K, Fink U et al (1999) Pretherapeutic laparoscopic staging in advanced gastric carcinoma. Endoscopy 31(5):342–347CrossRefPubMed

26.

Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355(1):11–20CrossRefPubMed

27.

Kodera Y, Yamamura Y, Ito S et al (2001) Is Borrmann type IV gastric carcinoma a surgical disease? An old problem revisited with reference to the result of peritoneal washing cytology. J Surg Oncol 78(3):175–181; discussion 181-182CrossRefPubMed

28.

Bryan RT, Cruickshank NR, Needham SJ et al (2001) Laparoscopic peritoneal lavage in staging gastric and oesophageal cancer. Eur J Surg Oncol 27(3):291–297CrossRefPubMed

29.

Fujimoto S, Takahashi M, Mutou T et al (1999) Successful intraperitoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer 85(3):529–534CrossRefPubMed

Title: Significance of Lavage Cytology in Advanced Gastric Cancer Patients
Authors: Takeo Fukagawa
Hitoshi Katai
Makoto Saka
Shinji Morita
Yuko Sasajima
Hirokazu Taniguchi
Takeshi Sano
Mitsuru Sasako
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-0355-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Significance of Lavage Cytology in Advanced Gastric Cancer Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2010

Complications Analysis with Postoperative Choledochoscopy for Residual Bile Duct Stones

Structured Ultrasonography Workshop for Breast Surgeons: Is It An Effective Training Tool?

Survey of Emergency and Surgical Capacity in the Conflict-Affected Regions of Sri Lanka

“Blitz Surgery”: Redefining Surgical Needs, Training, and Practice in Sub-Saharan Africa

Intrabiliary Rupture of Hepatic Echinococcosis, a Risk Factor for Developing Postoperative Morbidity: A Cohort Study

Cleft Lip and Palate as a Cost-effective Health Care Treatment in the Developing World