title: Incidence, time course and independent risk factors for metachronous peritoneal carcinomatosis of gastric origin--a longitudinal experience from a prospectively collected database of 1108 patients.
abstract: BACKGROUND
  Comprehensive evidence on the incidence, time course and independent risk factors of metachronous peritoneal carcinomatosis (metaPC) in gastric cancer patients treated with curative intent in the context of available systemic combination chemotherapies is lacking.
  
  
  METHODS
  Data from a prospectively collected single-institutional Center Cancer Registry with 1108 consecutive patients with gastric adenocarcinoma (GC), clinical, histological and survival data were analyzed for independent risk factors and prognosis with focus on the development of metaPC. Findings were then stratified to the time periods of treatment with surgery alone, 5-Fluorouracil-only and contemporary combined systemic perioperative chemotherapy strategies, respectively.
  
  
  RESULTS
  Despite R0 D2 gastrectomy (n = 560), 49.6% (±5.4%) of the patients were diagnosed with tumour recurrence and 15.5% (±1.8%) developed metaPC after a median time of 17.7 (15.1-20.3) months after surgery resulting in a tumour related mortality of 100% with a median survival of 3.0 months (2.1 - 4.0). Independent risk factors for the development of metaPC were serosa positive T-category, nodal positive-status, signet cell and undifferentiated gradings (G3/G4). Contemporary systemic combination chemotherapy did not improve the incidence and prognosis of metaPC (p = 0.54).
  
  
  CONCLUSIONS
  Despite significant improvements in the overall survival for the complete cohort with gastric cancer over time, those patients with metaPC did not experience the same benefits. The lack of change in the incidence, and persistent poor prognosis of metaPC after curative surgery expose the need for further prevention and/or improved treatment options for this devastating condition.
authors: Florian
authors: F
authors: Seyfried
authors: Burkhard H
authors: BH
authors: von Rahden
authors: Alexander D
authors: AD
authors: Miras
authors: Martin
authors: M
authors: Gasser
authors: Uwe
authors: U
authors: Maeder
authors: Volker
authors: V
authors: Kunzmann
authors: Christoph-Thomas
authors: CT
authors: Germer
authors: Jörg
authors: J
authors: Pelz
authors: Alexander G
authors: AG
authors: Kerscher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D010534:Peritoneal Neoplasms / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult