Abstract
We examined prognostic factors of gastric cancer invading the subserosal or deeper layers of the gastric wall with intraperitoneal free cancer cells and no macroscopic peritoneal dissemination (P0cy1 ss or deeper). Among consecutive 987 patients with gastric cancer invading the subserosal or deeper layers of the gastric wall, 86 patients with P0cy1 gastric cancer were enrolled in this study. Their median survival times (MST), one-, 2-, 3-, 4-, and 5-year survival rates were : 1678 days, 83%, 70%, 58%, 51%, and 48% ; 446 days, 56%, 30%, 21%, 14%, and 9.6% ; and 244 days, 36%, 18%, 11%, 3%, and 2% in P0cy0, P0cy1, and P1 gastric cancers, respectively. The prognosis of P0cy1 gastric cancers was proved to be the middle between those of P0cy0 and P1. Prognostic factors of P0cy1 gastric cancer by a univariate analysis were 14 factors including macroscopic type, liver metastasis, extent and number of lymph node metastasis, lymph node dissection, PM, DM, interstitial response, INF, lymphatic permeation, number and size of intraperitoneal free cancer cells, postoperative chemotherapy and chemotherapy. A multivariate analysis selected three prognostic factors including DM, lymph node dissection and postoperative chemotherapy.
Although P0cy1 gastric cancer carries poor prognosis, gastrectomy with D2 or more lymph node dissection, negative surgical margins and postoperative adjuvant chemotherapy would promise better prognosis for the patients with P0cy1 gastric cancer.
