J Gastric Cancer.  2011 Sep;11(3):167-172. 10.5230/jgc.2011.11.3.167.

Clinical Outcomes according to Primary Treatment in Gastric Cancer Patients with Peritoneal Seeding

• Bae JM
• Yeo KJ
• Kim SW
• Kim SW
• Song SK

• KMID: 2055514
• DOI: http://doi.org/10.5230/jgc.2011.11.3.167

Abstract

PURPOSE
Peritoneal seeding of gastric cancer is known to have a poor prognosis. With the diagnosis of peritoneal seeding, there is no effective treatment modality. Gastrectomy with chemotherapy or primary chemotherapy is basically one of major options for this condition. This study was conducted to compare the clinical outcomes of these treatments and to identify the better way to improve the prognosis of patients with peritoneal seeding.
MATERIALS AND METHODS
Between 2001 and 2007, gastric cancer patients with peritoneal seeding by preoperative or intraoperative diagnosis were reviewed retrospectively. The enrolled patients were divided as primary gastrectomy and primary chemotherapy group. Clinicopathologic characteristics and clinical outcomes of groups were analyzed and compared.
RESULTS
Fifty-four patients were enrolled. 21 patients belonged to the group of primary gastrectomy and 33 patients were to the primary chemotherapy group. Among 33 patients of the primary chemotherapy group, 17 patients were received only chemotherapy and 16 patients were received gastrectomy due to the good responses of primary chemotherapy. The 3 years survival rates were 14% in primary gastrectomy group, 55% in patients who received gastrectomy after primary chemotherapy, and 0% in patients with primary chemotherapy only.
CONCLUSIONS
Although this study had many limitations, some valuable information was produced. In terms of survival benefits for the gastric cancer patients with peritoneal seeding, primary gastrectomy and additional gastrectomy after primary chemotherapy revealed the better clinical outcomes. But, prospective randomized clinical study and multi-center study are should be performed to decide proper treatment for gastric cancer patients with peritoneal seeding.

Keyword

Gastric cancer; Peritoneal seeding; Chemotherapy; Gastrectomy

MeSH Terms

Gastrectomy
Humans
Prognosis
Retrospective Studies
Seeds
Stomach Neoplasms
Survival Rate

Figure

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  Fig. 1 Patients selection algorithm for the treatment of gastric cancer patients with peritoneal seeding.

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  Fig. 2 Survival curves for gastric cancer patients with peritoneal seeding according to primary treatment.

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