Reduced preoperative serum albumin and absence of peritoneal dissemination may be predictive factors for long-term survival with advanced gastric cancer with positive cytology test.
BACKGROUND
Peritoneal lavage cytology cancer-positive (CY1) is a critical prognostic factor and is taken as representing stage IV in gastric cancer. There is no consensus treatment strategy for CY1-gastric cancer, and the detailed clinicopathological features remain obscure.


PATIENTS AND METHODS
Among 790 gastric cancer patients between 2005 and 2009, 52 cases of CY1 were identified (6.6%). A multivariate prognostic model was applied to the univariate prognostic factors to identify independent prognostic factors and factors associated with long-term survival in CY1-gastric cancer.


RESULTS
(1) Five-year overall survival (OS) was 17.6% in CY1-gastric cancer as compared with 93.9% in CYX and 77.7% in CY0 (77.7%), where tumors with pT2 or beyond were included in 11% of CYX, 73% of CY0, and 98% of CY1 cases. (2) On univariate analysis, factors associated with a negative prognosis were the presence of peritoneal dissemination (p = 0.029) and high preoperative serum albumin (p = 0.011) in CY1-gastric cancer. The multivariate Cox proportional hazards and logistic regression model using propensity score identified preoperative albumin as a critical independent prognostic indicator. (3) Long-term survivors were identified and, were often characterized by long-term postoperative adjuvant treatment.


CONCLUSION
Reduced preoperative serum albumin and absence of peritoneal dissemination may be predictive factors for long-term survival in patients with advanced gastric cancer with positive cytology test. Long-term postoperative adjuvant therapy might improve survival of patients with CY1.
['Yamashita|K|K|', 'Ushiku|H|H|', 'Katada|N|N|', 'Hosoda|K|K|', 'Moriya|H|H|', 'Mieno|H|H|', 'Kikuchi|S|S|', 'Hoshi|K|K|', 'Watanabe|M|M|']
D000368:Aged D000369:Aged, 80 and over D000971:Antineoplastic Combined Chemotherapy Protocols D017024:Chemotherapy, Adjuvant D002945:Cisplatin D018572:Disease-Free Survival D000077143:Docetaxel D004338:Drug Combinations D005260:Female D005743:Gastrectomy D006801:Humans D034141:Hypoalbuminemia D016015:Logistic Models D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D010094:Oxonic Acid D010533:Peritoneal Lavage D010534:Peritoneal Neoplasms D057234:Preoperative Period D011379:Prognosis D016016:Proportional Hazards Models D012189:Retrospective Studies D012709:Serum Albumin D013274:Stomach Neoplasms D043823:Taxoids D005641:Tegafur
Albumin Peritoneal dissemination Gastric cancer CY1 Prognosis Propensity score Long-term postoperative therapy