Incidence, time course and independent risk factors for metachronous peritoneal carcinomatosis of gastric origin – a longitudinal experience from a prospectively collected database of 1108 patients

BMC Cancer

Alexander G Kerscher³  Jörg OW Pelz²  Christoph-Thomas Germer²  Volker Kunzmann⁴  Uwe Maeder¹  Martin Gasser²  Alexander D Miras⁵  Burkhard H von Rahden²  Florian Seyfried² 

[1]Cancer Registry Mainfranken, University of Wuerzburg Medical Center, Wuerzburg, Germany

[2]Department of General, Visceral, Vascular- and Pediatric Surgery, University of Wuerzburg Medical Center, Wuerzburg, Germany

[3]Comprehensive Cancer Center Mainfranken, University of Wuerzburg Medical Center, Wuerzburg, Germany

[4]Department of Internal Medicine, University of Wuerzburg Medical Center, Wuerzburg, Germany

[5]Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

关键词: Survival;    Recurrence;    Perioperative chemotherapy;    Risk factors;    Metachronous;    Peritoneal carcinomatosis;    Gastric cancer;   

Others  :  1131644
DOI  :  10.1186/s12885-015-1081-8

 received in 2014-11-29, accepted in 2015-02-11,  发布年份 2015

【 摘 要 】

Background

Comprehensive evidence on the incidence, time course and independent risk factors of metachronous peritoneal carcinomatosis (metaPC) in gastric cancer patients treated with curative intent in the context of available systemic combination chemotherapies is lacking.

Methods

Data from a prospectively collected single-institutional Center Cancer Registry with 1108 consecutive patients with gastric adenocarcinoma (GC), clinical, histological and survival data were analyzed for independent risk factors and prognosis with focus on the development of metaPC. Findings were then stratified to the time periods of treatment with surgery alone, 5-Fluorouracil-only and contemporary combined systemic perioperative chemotherapy strategies, respectively.

Results

Despite R0 D2 gastrectomy (n = 560), 49.6% (±5.4%) of the patients were diagnosed with tumour recurrence and 15.5% (±1.8%) developed metaPC after a median time of 17.7 (15.1-20.3) months after surgery resulting in a tumour related mortality of 100% with a median survival of 3.0 months (2.1 – 4.0). Independent risk factors for the development of metaPC were serosa positive T-category, nodal positive-status, signet cell and undifferentiated gradings (G3/G4). Contemporary systemic combination chemotherapy did not improve the incidence and prognosis of metaPC (p = 0.54).

Conclusions

Despite significant improvements in the overall survival for the complete cohort with gastric cancer over time, those patients with metaPC did not experience the same benefits. The lack of change in the incidence, and persistent poor prognosis of metaPC after curative surgery expose the need for further prevention and/or improved treatment options for this devastating condition.

【 授权许可】

   
2015 Seyfried et al.; licensee BioMed Central.

【 图 表 】

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