Prognostic re-evaluation of peritoneal lavage cytology in Japanese patients with gastric carcinoma.
OBJECTIVE
The aim of the present study was to re-evaluate CY(+) with gastric carcinoma in Japanese patients to identify the characteristics that might distinguish patients with a poor prognosis from those with an intermediate prognosis among CY(+) patients.


METHODS
CY(+) was found in 56 of 566 patients (9.9%) who had undergone surgery for gastric carcinoma between January 2000 and December 2006. The 56 patients with CY(+) were classified into four groups: group A, P(-)CY(+) (n = 10); group B, P1CY (+) (n = 10); group C, P2,3CY(+) (n = 18); group D, other (n = 18).


RESULTS
The 5-year survival of all patients with CY(+) was 12%. A multivariate analysis demonstrated serosal invasion, lymph node metastasis, and CY(+) to be independent prognostic factors. However, the 5-year survival in group A was 30%. The prognosis of group A patients was significantly better than that of patients in any other group (Groups B, C, D; p < 0.02). Sites of the recurrence in group A were located only in the peritoneum but the lymph nodes, etc.


CONCLUSIONS
Gastric carcinoma with CY(+) has a poor prognosis because it is associated with non-curative factors, peritoneal dissemination, and liver or lymph nodes metastases. However, a small subpopulation of patients with P(-)CY(+) showed an intermediate prognosis.
Yamamoto
Manabu
M
Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, 1-9-6, Senda-machi, Naka-ku, Hiroshima 730-8619, Japan. mayama@hiroshima-med.jrc.or.jp
Matsuyama
Ayumi
A
Kameyama
Toshifumi
T
Okamoto
Masahiro
M
Okazaki
Jin
J
Utsunomiya
Tohru
T
Tsutsui
Shinichi
S
Fujiwara
Megumu
M
Ishida
Teruyoshi
T
D002277:Carcinoma / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate