Ascites and malnutrition are predictive factors for incomplete cytoreductive surgery for peritoneal carcinomatosis from gastric cancer.
BACKGROUND
Prognosis in peritoneal carcinomatosis from gastric cancer has improved with cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy. The aim of this study was to identify predictive factors for incomplete CS.


METHODS
Forty-five patients undergoing laparotomy for gastric cancer with peritoneal carcinomatosis were prospectively included from January 2000 to December 2010. In case of optimal CS, patients (n = 14) received hyperthermic intraperitoneal chemotherapy. Otherwise, the laparotomy was closed or a palliative procedure was performed if necessary. All preoperative data were compared between the 2 groups.


RESULTS
Ascites (hazard ratio, .09; 95% confidence interval, .010-.48; P = .0103) and nutritional status evaluated by the prognostic nutrition index (hazard ratio, .11; 95% confidence interval, .0019-.54; P = .027) were independent predictive factors for incomplete CS.


CONCLUSIONS
The selection of patients for CS plus hyperthermic intraperitoneal chemotherapy should include the assessment of nutritional status and the detection of an ascites.
Department of General Surgery and Digestive Cancerology, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet 2, Nice, France. benizri.e@chu-nice.fr
Emmanuel I
EI
Benizri
Jean-Marc
JM
Bereder
Amine
A
Rahili
Jean-Louis
JL
Bernard
Daniel
D
Benchimol
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001201:Ascites / Q000150:complications*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D015999:Multivariate Analysis; D009752:Nutritional Status; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin