Peritoneal recurrence of gastric adenocarcinoma after curative resection.
OBJECTIVE
Death from gastric carcinoma after curative resection is mostly due to recurrence. The most common recurrence is peritoneal dissemination, which represents 33 to 50% of total recurrence after curative gastrectomy. Since survival after peritoneal dissemination is very poor, selection of high-risk patients for further management after resection may contribute to better survival.


METHODS
Based on a prospective database, a total of 1,092 patients with gastric carcinoma who underwent curative resection were included in this study. The incidence of peritoneal recurrence, disease-free interval and survival after peritoneal recurrence were determined. The clinicopathological factors including sex, age, tumor location, size, gross appearance, histological findings, depth of tumor invasion, lymph node status, tumor cell infiltration pattern were analyzed to see if there is any relationship with peritoneal dissemination.


RESULTS
The incidence of peritoneal recurrence after curative resection was 13.46%. The mean disease-free interval was 14.2 months and the survival after peritoneal recurrence was 4.9 months in average. Almost all the clinicopathological factors were related with peritoneal recurrence, but only depth of tumor invasion, gross appearance and tumor infiltration pattern are closely associated with peritoneal tumor dissemination after multivariate analyses.


CONCLUSIONS
Since the prognosis after peritoneal recurrence is so poor, selection of high-risk patients for further management after gastrectomy may be based on these three factors.
Lee
Chen-Chi
CC
Department of Surgery, Taipei-Veterans General Hospital, No. 201, Sec 2, Shih-pai Rd, Taipei, Taiwan.
Lo
Su-Shun
SS
Wu
Chew-Wun
CW
Shen
King-Han
KH
Li
Anna F
AF
Hsieh
Mao-Chih
MC
Lui
Wing-Yiu
WY
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery