Gross Appearance and Curability Are Predictive Factors of a Better Prognosis After Gastrectomy in Gastric Cancer Patients with Metastasis to the Adjacent Peritoneum of the Stomach.

BACKGROUND

Gastric cancer patients with peritoneal metastasis have an extremely poor prognosis. The aim of the current study was to clarify the predictive factors of a better outcome in gastric cancer patients with peritoneal metastasis.

METHODS

We analyzed the records of 2262 gastric adenocarcinoma patients who underwent gastrectomies at our institution between January 1980 and December 2010.

RESULTS

The 5-year survival rates for advanced gastric cancer patients with P1 ( = 43), P2 ( = 56), and P3 ( = 36) metastasis were 16.3%, 0%, and 0%, respectively. The prognosis of P1 gastric cancer patients was significantly better than that of either P2 ( = 0.0003) or P3 patients ( < 0.0001). A multivariate analysis identified gross appearance and curability as independent prognostic indicators in P1 gastric cancer patients. In fact, the prognosis was good for patients in whom an R0/1 resection had been performed and with tumors having a gross appearance of other than type 4, with a 40% 5-year survival rate and a 29-month median survival time.

CONCLUSION

Our data indicated a good prognosis for P1 patients in whom an R0/1 resection could be performed and with tumors having a gross appearance of other than type 4. Therefore, radical surgery and adequate adjuvant chemotherapy should be performed in these patients.