Kang Wen-Zhe, Zhong Yu-Xin, Ma Fu-Hai, Xue Li-Yan, Xiong Jian-Ping, Ma Shuai, Li Yang, Xie Yi-Bin, Quan Xu, Tian Yan-Tao
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bejing 100021, China.
World J Gastrointest Oncol. 2021 Jan 15;13(1):24-36. doi: 10.4251/wjgo.v13.i1.24.
Positive peritoneal wash cytology with no peritoneal metastasis (CY1P0) is a special type of distant gastric cancer metastasis, which describes a patient with positive peritoneal lavage cytology, but no definitive peritoneal metastasis, and there are no widely accepted treatment guidelines. We enrolled 48 primary CY1P0 gastric cancer patients treated by radical gastrectomy in this study. Our study illustrated the efficacy of radical gastrectomy for CY1P0 gastric cancer patients, and suggested that the pathological N factor and vascular invasion were significant independent risk factors for overall survival (OS).
To assess the survival of CY1P0 gastric cancer patient post-radical gastrectomy, and to identify factors associated with long-term prognosis.
Our study included 48 patients with primary CY1P0 gastric cancer who had radical gastrectomies at the Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China between 2013 and 2018. R0 resection was achieved in all 48 patients. Twelve patients received neoadjuvant chemotherapy. Thirty patients received adjuvant chemotherapy and four received adjuvant chemoradiotherapy. OS statistics were available for 48 patients. Follow-up continued through March 2020. Univariate and multivariate analyses were performed using a Cox proportional hazards model to identify prognostic factors.
Median OS was 22.0 mo (95% confidence interval: 13.366-30.634 mo) post-surgery. Univariate analyses demonstrated that tumor site ( = 0.021), pathological N factor ( = 0.001), pathological T factor ( = 0.028), vascular invasion ( = 0.046), and the level of CA199 prior to initiating therapy ( = 0.002) were significant risk factors for OS. Multivariate analyses demonstrated that pathological N factor ( = 0.001) and vascular invasion ( = 0.031) were significant independent risk factors for OS.
This study suggested that radical gastrectomy may be efficient for CY1P0 gastric cancer patient post-radical gastrectomy and the pathological N factor and vascular invasion are significant independent risk factors for OS.
腹膜冲洗细胞学检查阳性但无腹膜转移（CY1P0）是一种特殊类型的远处胃癌转移，指患者腹膜灌洗细胞学检查阳性，但无明确的腹膜转移，目前尚无广泛认可的治疗指南。本研究纳入了48例接受根治性胃切除术治疗的原发性CY1P0胃癌患者。我们的研究阐述了根治性胃切除术对CY1P0胃癌患者的疗效，并表明病理N因素和血管侵犯是总生存期（OS）的重要独立危险因素。
评估根治性胃切除术后CY1P0胃癌患者的生存情况，并确定与长期预后相关的因素。
我们的研究纳入了48例原发性CY1P0胃癌患者，这些患者于2013年至2018年在中国北京的中国医学科学院肿瘤医院接受了根治性胃切除术。48例患者均实现了R0切除。12例患者接受了新辅助化疗。30例患者接受了辅助化疗，4例接受了辅助放化疗。48例患者可获得OS统计数据。随访持续至2020年3月。采用Cox比例风险模型进行单因素和多因素分析以确定预后因素。
术后中位OS为22.0个月（95%置信区间：13.366 - 30.634个月）。单因素分析表明，肿瘤部位（P = 0.021）、病理N因素（P = 0.001）、病理T因素（P = 0.028）、血管侵犯（P = 0.046）以及开始治疗前CA199水平（P = 0.002）是OS的显著危险因素。多因素分析表明，病理N因素（P = 0.001）和血管侵犯（P = 0.031）是OS的显著独立危险因素。
本研究表明，根治性胃切除术对CY1P0胃癌患者可能有效，且病理N因素和血管侵犯是OS的重要独立危险因素。
