Erschienen in:
01.12.2011 | Gastrointestinal Oncology
Gastrectomy for Patients with Positive Peritoneal Cytology: Comments on the Article “Positive Peritoneal Cytology in Patients with Gastric Cancer: Natural History and Outcome of 291 Patients”
verfasst von:
Hiroshi Okabe, Yoshiharu Sakai
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 3/2011
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Excerpt
We read the article by Mezhir et al. in the December issue of
Annals of Surgical Oncology with interest.
1 They analyzed a cohort of 291 gastric cancer patients with positive peritoneal cytology and confirmed that these patients had a very poor prognosis, which has been shown by several previous studies. They also demonstrated that performance status, gross M1 disease, and tumor location were independent prognostic factors. Interestingly, their study included a subset of 93 patients with positive cytology without any evidence of gross M1 disease. These patients are described as “P0, CY1,” according to the Japanese Classification of Gastric Carcinoma (14th edition), and there have been many studies focusing on this patient population, although most of them are retrospective. Because prognostic value of positive peritoneal cytology (CY1) has not been proven previously, most patients in those case series studies underwent initial surgery and following 5-fluorouracil-based chemotherapy. The median survival time of these patients has been reported to be as short as 10–13 months, in accordance with the results of Mezhir et al.
2,
3 On this basis, we agree with their current strategy for P0, CY1 patients; systemic chemotherapy should be the initial therapy, unless the patients have symptoms requiring surgical intervention. …
