title: Prognosis and treatment of patients with positive peritoneal cytology in advanced gastric cancer.
abstract: Positive peritoneal cytology in gastric cancer is classified as M1 disease by the 7(th) Edition of American Joint Committee on Cancer staging system. With the introduction of laparoscopy and peritoneal washing cytology in the staging of gastric cancer a new category of patients has been identified. These are patients with no macroscopic peritoneal metastases but with peritoneal cytology positive (P0C1). Prognosis and treatment of such patients represent a controversial issue. We evaluate the state of the art of staging system in gastric cancer and discuss standardisation in staging and treatment procedures. There is still a lack of uniformity in the use of laparoscopy with peritoneal cytology in clinical decision making and in the surgical treatment for gastric cancer. Survival of this patient subset remains poor. Multimodal therapies and new therapeutic strategies are required to improve the survival of these patients.
authors.affiliation: Francesco Frattini, Stefano Rausei, Corrado Chiappa, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgical Sciences, University of Insubria School of Medicine, 21100 Varese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Frattini
authors.forename: Stefano
authors.initials: S
authors.lastname: Rausei
authors.forename: Corrado
authors.initials: C
authors.lastname: Chiappa
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
keywords: Advanced gastric cancer; Peritoneal washing cytology; Reverse transcription-polymerase chain reaction; Staging laparoscopy