title: Factors correlated with peritoneal carcinomatosis and survival in patients with gastric cancer treated at a single institution in Brazil.
abstract: BACKGROUND
  Gastric cancer is the second leading cause of death due to cancer worldwide and is particularly prevalent in Brazil. Promising new therapeutic agents have already shown activity in some gastrointestinal malignancies and their role in gastric cancer will need to be evaluated. Determining the prognostic factors of survival for patients with gastric cancer can help in identifying patients with a worse prognosis after treatment with the current chemotherapeutic regimens.
  
  
  METHODS
  A retrospective chart review of 186 patients diagnosed with gastric cancer 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 peritoneal metastasis at diagnosis and with overall survival.
  
  
  RESULTS
  Of the 186 patients, 76 were alive at the time of this analysis. The median survival for all patients was 30.1 months. Two independent factors associated with the presence of peritoneal metastasis at diagnosis were identified by multivariate analysis: signet-ring cell type (odds ratio [OR], 10.8; 95% confidence interval [CI], 3.1 to 37.5), and visceral metastasis (OR, 51.8; 95% CI, 12.4 to 215.4). The prognostic factors for poor survival were tumor stage T3 or T4 (hazard ratio [HR], 1.87; 95% CI, 1.09 to 3.22) and visceral metastasis (HR, 4.98; 95% CI, 3.02 to 8.20).
  
  
  CONCLUSIONS
  Two factors correlated with peritoneal metastasis and two prognostic factors for survival were identified. These findings may contribute to clinical decision-making, treatment tailoring, and the design of future trials.
authors.affiliation: Fundação Antônio Prudente, Hospital do Câncer A.C. Camargo, Rua Professor Antônio Prudente 211, Liberdade, São Paulo, SP, Brazil. marcello.fanelli@hcancer.org.br
authors.forename: Marcello F
authors.initials: MF
authors.lastname: Fanelli
authors.forename: Milton J B
authors.initials: MJ
authors.lastname: Silva
authors.forename: Tadeu F
authors.initials: TF
authors.lastname: de Paiva
authors.forename: Ludmilla T D
authors.initials: LT
authors.lastname: Chinen
authors.forename: Andréa P G
authors.initials: AP
authors.lastname: Guimarães
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Gimenes
authors.forename: Edilson D
authors.initials: ED
authors.lastname: Pinheiro
authors.forename: José A
authors.initials: JA
authors.lastname: Rinck
authors.forename: Ulisses R
authors.initials: UR
authors.lastname: Nicolau
authors.forename: Solange M
authors.initials: SM
authors.lastname: Sanches
authors.forename: Celso A L
authors.initials: CA
authors.lastname: Melo
authors.forename: Aldo L A
authors.initials: AL
authors.lastname: Dettino
authors.forename: Marcelo R S
authors.initials: MR
authors.lastname: Cruz
authors.forename: Leila Maria M P
authors.initials: LM
authors.lastname: de Melo
authors.forename: Maria N C
authors.initials: MN
authors.lastname: Formiga
authors.forename: Vladmir C C
authors.initials: VC
authors.lastname: de Lima
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
references.citation: World J Surg. 1984 Jun;8(3):308-14
references.pmid: 6464487
references.citation: Int J Cancer. 2004 Jun 10;110(2):155-69
references.pmid: 15069676
references.citation: N Engl J Med. 2004 Jun 3;350(23):2335-42
references.pmid: 15175435
references.citation: J Natl Cancer Inst. 2006 Apr 19;98(8):529-34
references.pmid: 16622122
references.citation: J Clin Oncol. 1984 Apr;2(4):305-10
references.pmid: 6707718
references.citation: J Clin Oncol. 1999 Aug;17(8):2530-40
references.pmid: 10561319
references.citation: Br J Surg. 2007 Jun;94(6):737-42
references.pmid: 17330827
references.citation: Nat Rev Cancer. 2005 Aug;5(8):591-602
references.pmid: 16056258
references.citation: Ann Oncol. 2004 Feb;15(2):338-45
references.pmid: 14760131
references.citation: J Clin Oncol. 2004 Jun 15;22(12):2395-403
references.pmid: 15197201
references.citation: Gastric Cancer. 1998 Mar;1(2):125-133
references.pmid: 11957056
references.citation: Jpn J Clin Oncol. 2004 Nov;34(11):654-9
references.pmid: 15613554
references.citation: Lancet Oncol. 2001 Sep;2(9):533-43
references.pmid: 11905707
references.citation: World J Surg. 1995 Jul-Aug;19(4):496-500
references.pmid: 7676690
references.citation: J Clin Oncol. 2005 May 20;23(15):3412-20
references.pmid: 15809451
references.citation: Gastric Cancer. 2000 Aug 4;3(1):9-18
references.pmid: 11984703
references.citation: Lancet. 2006 Oct 14;368(9544):1329-38
references.pmid: 17046465
references.citation: J Clin Oncol. 2005 May 1;23(13):3094-103
references.pmid: 15860869
references.citation: Nat Clin Pract Oncol. 2005 Feb;2(2):98-107
references.pmid: 16264882
references.citation: Ann Surg Oncol. 2006 Jun;13(6):843-50
references.pmid: 16614885
references.citation: J Clin Oncol. 2006 May 10;24(14):2137-50
references.pmid: 16682732
references.citation: Cancer. 2007 Nov 15;110(10):2186-90
references.pmid: 17896785
references.citation: Oncology. 2007;72(1-2):64-8
references.pmid: 18004078
references.citation: Semin Oncol. 1985 Mar;12(1):21-31
references.pmid: 3975644
references.citation: Cancer Chemother Pharmacol. 2008 Feb;61(2):301-7
references.pmid: 17429626
references.citation: Am J Surg. 1983 Feb;145(2):226-33
references.pmid: 6824136
references.citation: Eur J Cancer. 2001 Sep;37(13):1674-80
references.pmid: 11527695
references.citation: Med Sci Monit. 2006 May;12(5):CR221-9
references.pmid: 16641880
references.citation: N Engl J Med. 2004 Jul 22;351(4):337-45
references.pmid: 15269313
references.citation: Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1401-9
references.pmid: 16472935
references.citation: Ann Oncol. 2007 May;18(5):886-91
references.pmid: 17298958
references.citation: Cancer. 2006 Dec 1;107(11):2576-80
references.pmid: 17075877
references.citation: N Engl J Med. 2002 Aug 15;347(7):472-80
references.pmid: 12181401
references.citation: Ann Surg Oncol. 2008 May;15(5):1464-9
references.pmid: 18340495
references.citation: N Engl J Med. 1993 Sep 30;329(14):987-94
references.pmid: 8141877