Factors correlated with peritoneal carcinomatosis and survival in patients with gastric cancer treated at a single institution in Brazil.
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.
Fanelli
Marcello F
MF
Fundação Antônio Prudente, Hospital do Câncer A.C. Camargo, Rua Professor Antônio Prudente 211, Liberdade, São Paulo, SP, Brazil. marcello.fanelli@hcancer.org.br
Silva
Milton J B
MJ
de Paiva
Tadeu F
TF
Chinen
Ludmilla T D
LT
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
Melo
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
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
D000970:Antineoplastic Agents
World J Surg. 1984 Jun;8(3):308-14
6464487
Int J Cancer. 2004 Jun 10;110(2):155-69
15069676
N Engl J Med. 2004 Jun 3;350(23):2335-42
15175435
J Natl Cancer Inst. 2006 Apr 19;98(8):529-34
16622122
J Clin Oncol. 1984 Apr;2(4):305-10
6707718
J Clin Oncol. 1999 Aug;17(8):2530-40
10561319
Br J Surg. 2007 Jun;94(6):737-42
17330827
Nat Rev Cancer. 2005 Aug;5(8):591-602
16056258
Ann Oncol. 2004 Feb;15(2):338-45
14760131
J Clin Oncol. 2004 Jun 15;22(12):2395-403
15197201
Gastric Cancer. 1998 Mar;1(2):125-133
11957056
Jpn J Clin Oncol. 2004 Nov;34(11):654-9
15613554
Lancet Oncol. 2001 Sep;2(9):533-43
11905707
World J Surg. 1995 Jul-Aug;19(4):496-500
7676690
J Clin Oncol. 2005 May 20;23(15):3412-20
15809451
Gastric Cancer. 2000 Aug 4;3(1):9-18
11984703
Lancet. 2006 Oct 14;368(9544):1329-38
17046465
J Clin Oncol. 2005 May 1;23(13):3094-103
15860869
Nat Clin Pract Oncol. 2005 Feb;2(2):98-107
16264882
Ann Surg Oncol. 2006 Jun;13(6):843-50
16614885
J Clin Oncol. 2006 May 10;24(14):2137-50
16682732
Cancer. 2007 Nov 15;110(10):2186-90
17896785
Oncology. 2007;72(1-2):64-8
18004078
Semin Oncol. 1985 Mar;12(1):21-31
3975644
Cancer Chemother Pharmacol. 2008 Feb;61(2):301-7
17429626
Am J Surg. 1983 Feb;145(2):226-33
6824136
Eur J Cancer. 2001 Sep;37(13):1674-80
11527695
Med Sci Monit. 2006 May;12(5):CR221-9
16641880
N Engl J Med. 2004 Jul 22;351(4):337-45
15269313
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1401-9
16472935
Ann Oncol. 2007 May;18(5):886-91
17298958
Cancer. 2006 Dec 1;107(11):2576-80
17075877
N Engl J Med. 2002 Aug 15;347(7):472-80
12181401
Ann Surg Oncol. 2008 May;15(5):1464-9
18340495
N Engl J Med. 1993 Sep 30;329(14):987-94
8141877