title: [Impact of cytoreductive surgery on survival in gastric cancer patients with peritoneal metastasis].
abstract: OBJECTIVE
  To investigate the survival benefit of cytoreductive surgery in gastric cancer patients with peritoneal metastasis.
  
  
  METHODS
  Clinicopathological data of 151 advanced gastric adenocarcinoma patients with extensive peritoneal metastasis who were identified by surgical exploration between May 2008 and April 2015 in Xijing Hospital of Digestive Diseases were analyzed retrospectively. Of all the patients, 32 cases were treated by cytoreductive surgery with local radical tumor resection and regional lymph node cleaning, combined with fluorouracil-based adjuvant chemotherapy after surgery (cytoreductive surgery combined with chemotherapy group); 39 caseswere only treated by cytoreductive surgery group(cytoreductive surgery group);23 caseswere treated bysurgical exploration combined with fluorouracil-based adjuvant chemotherapy after surgery(surgical exploration combined with chemotherapy group) and 57 cases were only treated bysurgical exploration (surgical exploration group). The overall survival of four groups were analyzed and compared.
  
  
  RESULTS
  Among the 151 patients, 148 (98.0%) patients were followed up. The median follow up time was 7.2 months (range 1.4-61.2). The median survival of cytoreductive surgery combined with chemotherapy group, cytoreductive surgery group, surgical exploration combined with chemotherapy group and surgical exploration group was 11.9(95% CI: 8.8-15.1) months, 7.1(95% CI: 3.2-11.1) months, 8.2(95% CI:4.6-11.8) and 5.4(95% CI:4.4-6.4) months, respectively(P < 0.01).
  
  
  CONCLUSIONS
  Cytoreductive surgery can prolong the survival of gastric adenocarcinoma patients with extensive peritoneal metastasis. Cytoreductive surgery combined with chemotherapy may provide more benefit for patients, and can be used as a choice of treatment in these patients.
authors.forename: Shushang
authors.initials: S
authors.lastname: Liu
authors.forename: Ke
authors.initials: K
authors.lastname: Liu
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: Nai
authors.forename: Shuao
authors.initials: S
authors.lastname: Xiao
authors.forename: Man
authors.initials: M
authors.lastname: Guo
authors.forename: Xiao
authors.initials: X
authors.lastname: Lian
authors.forename: Xuewen
authors.initials: X
authors.lastname: Yang
authors.forename: Jinqiang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China. zhanghw@fmmu.edu.cn.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma; D000971:Antineoplastic Combined Chemotherapy Protocols; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures; D006801:Humans; D008198:Lymph Nodes; D010534:Peritoneal Neoplasms / Q000556:secondary; D012189:Retrospective Studies; D013274:Stomach Neoplasms