Prognostic value of peritoneal lavage cytology and chemotherapy during surgery for advanced gastric cancer.

BACKGROUND

The prognostic value of intra-operative peritoneal lavage cytology and chemotherapy was evaluated retrospectively.

METHOD

Lavage cytology was performed in 257 patients. Prognosis was investigated in 85 of pT3 and pT4 patients with radical gastrectomy. Intra-operative chemotherapy was selected according to the cytology and exploration of the peritoneal cavity. For patients forecasted to have peritoneal recurrence, intraperitoneal injection of cisplatin was performed.

RESULTS

No free cancer cells (cy(-)) were found in pTis, pT1 and pT2. In pT3 and pT4, cy(-) were 82.8% of the cases without macroscopic metastasis (P(-)), and the presence of free cancer cells (cy(+)) were 89.3% of the cases with macroscopic metastasis (P(+)). Intraperitoneal injection was performed in about 60% of P(-)/cy(+) and P(+) cases. Five-year survival rate of P(-)/cy(-) was 41.7% and that of P(-)/cy(+) was 33.3%. All of P(+) died within 3 years.

CONCLUSION

Patients of P(-)/cy(+) probably had microscopic residual disease and might benefit from intraperitoneal chemotherapy.