Strategy for patients with cytology positive and peritoneal dissemination from gastric cancer

The aim of this study was to evaluate the strategy for patients with cytology positive and peritoneal dissemination from gastric cancer. Thirty eight of POCY1, three of P1, eight of P2 and thirty six of P3 from advanced gastric adenocarcinoma at staging laparoscopy were studied. Gastrectomy after staging laparoscopy was performed in 10 patients (Surgery group). NAC following gastrectomy after staging laparoscopy was performed in 31 patients (NAC group) in POCY1, P1. The overall response rate was 29%, twenty of the 31 patients (65%) in the NAC group revealed no free cancer cells at the operation. The overall 5-year survival rate in 41 patients of POCY1, P1 was 15%. There was a significant deference in the overall survival curves between Surgery and NAC groups. The overall 2-year survival rate in 44 patients of P2, P3 was 9%. NAC for patients with positive cytology could lead into free cancer cells at a high rate, but not to improve their prognoses. An intensive chemotherapy including intra-abdominal chemotherapy should be necessary for these patients.