Significance of lavage cytology in advanced gastric cancer patients.
BACKGROUND
Lavage cytology positive (Cy1) is well known as a poor prognostic factor in advanced gastric cancer patients. However, the optimal therapeutic strategy for patients with Cy1 has not yet been established. The aim of this study was to evaluate the clinical significance of Cy1 for the purpose of establishing a suitable therapeutic strategy.


METHODS
The data of 996 consecutive advanced gastric cancer patients who underwent gastrectomy between 1992 and 1998 at the National Cancer Center Hospital were retrospectively studied.


RESULTS
The 2- and 5-year survival rates of the patients who underwent gastrectomy without any other noncurative factors besides Cy1 were 25.3 and 7.8%, respectively. When the analysis was limited to type 4 advanced gastric cancer patients, none of the patients with Cy1 survived for more than 40 months.


CONCLUSIONS
The prognosis of gastric cancer patients with Cy1 is very poor. Some patients show long survival after standard gastrectomy with D2 lymph node dissection; however, the prognosis of type 4 gastric cancer patients with Cy1 is so poor that multimodality therapy, including perioperative chemotherapy, is essential.
Fukagawa
Takeo
T
Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. tfukagaw@ncc.go.jp
Katai
Hitoshi
H
Saka
Makoto
M
Morita
Shinji
S
Sasajima
Yuko
Y
Taniguchi
Hirokazu
H
Sano
Takeshi
T
Sasako
Mitsuru
M
D005743:Gastrectomy / Q000401:mortality; D005751:Gastric Lavage; D006801:Humans; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate