title: [Outcome of therapy for type 4 gastric cancer with peritoneal metastasis--diagnosis by laparoscopy and effect of chemotherapy].
abstract: Laparoscopy (st-lap) was performed for type 4 advanced gastric cancer cases, and chemotherapy was performed for P1 or CY1[ P(+)] cases. We present the results here.
  
  
  METHODS
  The subjects were type 4 advanced gastric cancer cases from October 2002 to December 2007 who underwent st-lap, as well as 7 P0 and CY0 [P(-)] cases (the operative group), and 18 P(+) cases which underwent chemotherapy (the chemotherapy group). The administration of S-1 (80 mg/m2: days 1-14)+PTX (120 mg/m2: day 1) every 3 weeks was the basic regimen of chemotherapy.
  
  
  RESULTS
  After 5- course of chemotherapy, st-lap was performed in 11-PR case(61%) and 4-SD case, in which clinical symptoms had improved. An operation was performed for 11-P(-) case. Overall, there was 8-P(-) case(44%). The 1-and 3-year survival rates in the chemotherapy group in the 11 cases for which an operation was performed were 82 and 36%, respectively, and the 7 non-operative cases were 57 and 14%, respectively. Although there were no significant differences, the outcome was more favorable in the operative group. The 1-and 2-year survival rates in the operative and chemotherapy groups were 72, 39, 51 and 34%, respectively, and there was no significant difference.
  
  
  CONCLUSIONS
  It was suggested that in cases of type 4 advanced gastric cancer, chemotherapy was necessary not only in P(+) but also in P(-) cases. Further investigation regarding the necessity of resection and choice of therapeutic regimen is required.
authors.affiliation: Department of Surgery, Kansai Rosai Hospital.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Tamura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Miki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Okada
authors.forename: Mio
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Kumiko
authors.initials: K
authors.lastname: Uji
authors.forename: Atsuko
authors.initials: A
authors.lastname: Yoshida
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Rei
authors.initials: R
authors.lastname: Suzuki
authors.forename: Shin
authors.initials: S
authors.lastname: Nakahira
authors.forename: Chiyomi
authors.initials: C
authors.lastname: Egawa
authors.forename: Ken
authors.initials: K
authors.lastname: Nakata
authors.forename: Shu
authors.initials: S
authors.lastname: Okamura
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takatsuka
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D010535:Laparoscopy; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000556:secondary*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel