title: Comparison of Neoadjuvant Chemotherapy to Surgery Followed by Adjuvant Chemotherapy in Japanese Patients with Peritoneal Lavage Cytology Positive for Gastric Carcinoma.
abstract: BACKGROUND
  Therapeutic strategies for positive peritoneal lavage cytology [CY(+)] findings have not yet been established. The aim of the present study was to compare the effects of neoadjuvant systemic chemotherapy and surgery followed by S-1 adjuvant chemotherapy for treating gastric carcinoma in patients with CY(+) status without peritoneal metastasis.
  
  
  METHODS
  Twenty-three patients with CY(+) status without peritoneal metastasis who underwent curative surgery for gastric carcinoma between October 1999 and December 2014 were included in the study. Ten patients received neoadjuvant systemic chemotherapy followed by surgery, whereas 13 patients underwent surgery, in nine cases followed by S-1 adjuvant chemotherapy.
  
  
  RESULTS
  The 5-year survival in both groups was 15%, and no significant difference was observed. However, the prognosis for patients with CY(-) status after neoadjuvant systemic chemotherapy was significantly better than that of patients who were still CY(+) after neoadjuvant systemic chemotherapy (p<0.01). Among all patients, the prognosis of those with less than clinical N2 disease was significantly better than that of patients with clinical N3 (p<0.01). In multivariate analysis, clinical lymph node metastasis was the only independent prognostic factor for CY(+) patients without peritoneal metastasis (p<0.05).
  
  
  CONCLUSIONS
  The prognosis of gastric carcinoma with CY(+) without peritoneal metastasis is still stage IV disease and is dependent on the degree of clinical lymph node metastasis, in spite of therapeutic treatment.
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan yamamoto.m@nk-cc.go.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Egashira
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Minami
authors.affiliation: Department of Pathology, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Taguchi
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
mesh_terms: D000368:Aged; D044466:Asian People; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000556:secondary; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
keywords: Gastric carcinoma; neoadjuvant chemotherapy; peritoneal washing