Predictors of peritoneal carcinomatosis in patients with gastric cancer treated at a single institution in Brazil.
BACKGROUND
Peritoneal carcinomatosis is a common pattern of recurrence in gastric cancer and is associated with a poor prognosis. Determining predictive factors for peritoneal recurrence can help the selection of patients suitable for more aggressive treatment strategies.


METHODS
A retrospective chart review of 162 patients diagnosed with gastric cancer with no peritoneal carcinomatosis and treated at a single institution in Brazil from January 1994 to December 2004 was carried out. Univariate and multivariate analyses were performed to identify patient and tumor-related characteristics associated with the development of peritoneal metastasis.


RESULTS
Twenty-three (14.2%) patients developed peritoneal carcinomatosis. Three independent factors associated with the development of peritoneal metastasis were identified by multivariate analysis: signet-ring cell histology (odds ratio [OR] = 4.9; P = 0.018), the presence of vascular invasion (OR = 4.8; P = 0.022), and the presence of visceral metastasis at diagnosis (OR = 5.1; P = 0.011). Tumor stages T3 or T4 showed a trend towards significance (P = 0.062).


CONCLUSIONS
Patients with gastric cancer presenting with signet-ring histology, vascular invasion, or visceral metastasis appear to be at higher risk for the development of peritoneal carcinomatosis.
Fanelli
Marcello F
MF
Fundação Antônio Prudente, Hospital do Câncer A. C. Camargo, São Paulo, SP 01509-900, Brazil. marcello.fanelli@hcancer.org.br
de Paiva
Tadeu F
TF
Silva
Milton J B
MJ
Benevides
Carlos F L
CF
Guimarães
Andréa P G
AP
Gimenes
Daniel L
DL
Pinheiro
Edilson D
ED
Rinck
José A
JA
Nicolau
Ulisses R
UR
Sanches
Solange M
SM
Mello
Celso A L
CA
Dettino
Aldo L A
AL
Cruz
Marcelo R S
MR
de Melo
Leila Maria M P
LM
Formiga
Maria N C
MN
de Lima
Vladmir C C
VC
Chinen
Ludmilla T D
LT
D000328:Adult; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000473:pathology* / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy