Skip to main content

Advertisement

SpringerLink
Log in

Macroscopic type is implicated in the prognostic impact of initial chemotherapy on peritoneal lavage cytology-positive gastric cancer with no other noncurative factors

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Initial chemotherapy (Initial-C) followed by surgery is a promising treatment strategy for peritoneal lavage cytology-positive gastric cancer (CY1 GC) with no other noncurative factors. The aim of this study was to investigate the survival advantage of Initial-C compared to initial surgery (Initial-S) for this disease according to the macroscopic type, which was associated with prognosis and the efficacy of chemotherapy in GC.

Methods

One hundred eighty-nine patients who were diagnosed with CY1 GC with no other noncurative factors at four institutions from January 2007 to December 2018 were enrolled. The patients were divided into a macroscopic type 4 group (N = 48) and a non-type 4 group (N = 141). The influence of initial treatment on overall survival (OS) in each group was evaluated.

Results

In the type 4 group, the 5-year OS rates of Initial-C (N = 35) and Initial-S (N = 13) were 11.6% and 0%, respectively (P = 0.801). The multivariate analysis could not show the survival advantage of Initial-C. In the non-type 4 group, the 5-year OS rates of Initial-C (N = 41) and Initial-S (N = 100) were 48.4% and 29.0%, respectively (P = 0.020). The multivariate analysis revealed that Initial-C was independently associated with prolonged OS (hazard ratio, 0.591; 95% confidence interval, 0.375–0.933: P = 0.023).

Conclusions

Initial-C improves the prognosis of non-type 4 CY1 GC with no other noncurative factors. On the other hand, further development of effective chemotherapeutic regimens and innovative treatment strategies are required for type 4 CY1 GC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Brierley JD, Gospodarowicz MK, Wittekind C (2017) International union against cancer (UICC) TNM classification of malignant tumours, 8th edn. John Wiley & Sons, Hoboken

    Google Scholar 

  2. Amin MB, Edge SB, Greene FL et al (2017) AJCC cancer staging manual, 8th edn. Springer, New York

    Google Scholar 

  3. Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–12

    Article  Google Scholar 

  4. Jamel S, Markar SR, Malietzis G et al (2018) Prognostic significance of peritoneal lavage cytology in staging gastric cancer: systematic review and meta-analysis. Gastric Cancer 21:10–18

    Article  CAS  PubMed  Google Scholar 

  5. Ajani JA, D’Amico TA, Bentrem DJ et al (2022) Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 20:167–92

    Article  CAS  PubMed  Google Scholar 

  6. Lordick F, Carneiro F, Cascinu S et al (2022) ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol 33:1005–1020

    Article  CAS  PubMed  Google Scholar 

  7. Kodera Y, Ito S, Mochizuki Y et al (2012) Long term follow up of patients who were positive for peritoneal lavage cytology:fnal report from the CCOG0301 study. Gastric Cancer 15:335–337

    Article  PubMed  Google Scholar 

  8. Kano Y, Ichikawa H, Hanyu T et al (2022) Conversion surgery for stage IV gastric cancer: a multicenter retrospective study. BMC Surg 14(22):428

    Article  Google Scholar 

  9. Solaini L, Ministrini S, Bencivenga M et al (2019) Conversion gastrectomy for stage IV unresectable gastric cancer: a IRCG retrospective cohort study. Gastric Cancer 22:1285–1293

    Article  CAS  PubMed  Google Scholar 

  10. Yoshida K, Yasufuku I, Terashima M et al (2021) CONVO-GC-1 study group, federation of Asian clinical oncology (FACO). International retrospective cohort study of conversion therapy for stage IV gastric cancer 1 (CONVO-GC-1). Ann Gastroenterol Surg 6:227–40

    Article  PubMed  PubMed Central  Google Scholar 

  11. Yamaguchi K, Yoshida K, Tanahashi T et al (2018) The long-term survival of stage IV gastric cancer patients with conversion therapy. Gastric Cancer 21:315–323

    Article  CAS  PubMed  Google Scholar 

  12. Yasufuku I, Nunobe S, Ida S et al (2020) Conversion therapy for peritoneal lavage cytology-positive type 4 and large type 3 gastric cancer patients selected as candidates for R0 resection by diagnostic staging laparoscopy. Gastric Cancer 23:319–327

    Article  CAS  PubMed  Google Scholar 

  13. Aizawa M, Nashimoto A, Yabusaki H et al (2015) The clinical significance of potentially curative resection for gastric cancer following the clearance of free cancer cells in the peritoneal cavity by induction chemotherapy. Surg Today 45:611–617

    Article  CAS  PubMed  Google Scholar 

  14. Nakamura M, Ojima T, Nakamori M et al (2019) Conversion surgery for gastric cancer with peritoneal metastasis based on the diagnosis of second-look staging laparoscopy. J Gastrointest Surg 23:1758–1766

    Article  PubMed  Google Scholar 

  15. Yamaguchi T, Takashima A, Nagashima K et al (2021) Impact of preoperative chemotherapy as initial treatment for advanced gastric cancer with peritoneal metastasis limited to positive peritoneal lavage cytology (CY1) or localized peritoneal metastasis (P1a): a multi-institutional retrospective study. Gastric Cancer 24:701–709

    Article  CAS  PubMed  Google Scholar 

  16. Bollschweiler E, Boettcher K, Hoelscher AH et al (1993) Is the prognosis for Japanese and German patients with gastric cancer really different? Cancer 71:2918–2925

    Article  CAS  PubMed  Google Scholar 

  17. Blackham AU, Swords DS, Levine EA et al (2016) Is linitis plastica a contraindication for surgical resection: a multi-institution study of the U.S. Gastric cancer collaborative. Ann Surg Oncol 23:1203–11

    Article  PubMed  Google Scholar 

  18. An JY, Kang TH, Choi MG et al (2008) Borrmann type IV: an independent prognostic factor for survival in gastric cancer. J Gastrointest Surg 12:1364–1369

    Article  PubMed  Google Scholar 

  19. Song XH, Zhang WH, Kai Liu et al (2020) Prognostic impact of Borrmann classification on advanced gastric cancer: a retrospective cohort from a single institution in western China. World J Surg Oncol 18:204

    Article  PubMed  PubMed Central  Google Scholar 

  20. Eba J, Nakamura K (2022) Overview of the ethical guidelines for medical and biological research involving human subjects in Japan. Jpn J Clin Oncol 52:539–544

    Article  PubMed  PubMed Central  Google Scholar 

  21. Japanese Gastric Cancer Association (2021) Japanese gastric cancer treatment guidelines 2018. Gastric Cancer 24:1–21

    Article  Google Scholar 

  22. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  23. Smyth EC, Nilsson M, Grabsch HI et al (2020) Gastric cancer. Lancet 396:635–648

    Article  CAS  PubMed  Google Scholar 

  24. Piessen G, Messager M, Leteurtre E et al (2009) Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887

    Article  PubMed  Google Scholar 

  25. Heger U, Blank S, Wiecha C et al (2014) Is preoperative chemotherapy followed by surgery the appropriate treatment for signet ring cell containing adenocarcinomas of the esophagogastric junction and stomach? Ann Surg Oncol 21:1739–1748

    Article  PubMed  Google Scholar 

  26. Koseki Y, Hatakeyama K, Terashima M et al (2023) Molecular profile of poorly cohesive gastric carcinoma with special reference to survival. Gastric Cancer 26:553–64

    Article  CAS  PubMed  Google Scholar 

  27. Fukagawa T, Katai H, Saka M et al (2010) Significance of lavage cytology in advanced gastric cancer patients. World J Surg 34:563–568

    Article  PubMed  Google Scholar 

  28. Endo S, Ikenaga M, Ohta K et al (2019) Prognostic factors for cytology-positive gastric cancer. Surg Today 49:56–64

    Article  PubMed  Google Scholar 

  29. Kano K, Aoyama T, Maezawa Y et al (2017) The survival and prognosticators of peritoneal cytology-positive gastric cancer patients who received upfront gastrectomy and subsequent S-1 chemotherapy. Int J Clin Oncol 22:887–896

    Article  CAS  PubMed  Google Scholar 

  30. Yago A, Haruta S, Ueno M et al (2022) Clinical significance of initial treatment for peritoneal lavage cytology-positive gastric cancer: outcomes according to treatment strategy. World J Surg Oncol 20:35

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kuramoto M, Shimada S, Ikeshima S et al (2009) Extensive intraoperative peritoneal lavage as a standard prophylactic strategy for peritoneal recurrence in patients with gastric carcinoma. Ann Surg 250:242–246

    Article  PubMed  Google Scholar 

  32. Yamaguchi T, Takashima A, Nagashima K et al (2020) Efficacy of postoperative chemotherapy after resection that leaves no macroscopically visible disease of gastric cancer with positive peritoneal lavage cytology (CY1) or localized peritoneum metastasis (P1a): a multicenter retrospective study. Ann Surg Oncol 27:284–292

    Article  PubMed  Google Scholar 

  33. Iwasaki Y, Terashima M, Mizusawa J et al (2021) Gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer (JCOG0501): an open-label, phase 3, randomized controlled trial. Gastric Cancer 24:492–502

    Article  CAS  PubMed  Google Scholar 

  34. Chen GM, Yuan SQ, Nie RC et al (2020) Surgical outcome and long-term survival of conversion surgery for advanced gastric cancer. Ann Surg Oncol 27:4250–4260

    Article  PubMed  Google Scholar 

  35. Lee JH, Son SY, Lee CM et al (2014) Factors predicting peritoneal recurrence in advanced gastric cancer: implication for adjuvant intraperitoneal chemotherapy. Gastric Cancer 17:529–536

    Article  CAS  PubMed  Google Scholar 

  36. Ishigami H, Fujiwara Y, Fukushima R et al (2018) Phase III trial comparing intraperitoneal and intravenous paclitaxel plus S-1 versus cisplatin plus S-1 in patients with gastric cancer with peritoneal metastasis: PHOENIX-GC trial. J Clin Oncol 36:1922–1929

    Article  CAS  PubMed  Google Scholar 

  37. Ishigami H, Tsuji Y, Shinohara H et al (2021) Intraperitoneal chemotherapy as adjuvant or perioperative chemotherapy for patients with type 4 scirrhous gastric cancer: PHOENIX-GC2 trial. J Clin Med 10:5666

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by JSPS KAKENHI Grant Number JP22K16483.

Author information

Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    Yosuke Kano, Hiroshi Ichikawa, Yusuke Muneoka, Kenji Usui, Takaaki Hanyu, Takashi Ishikawa, Kohei Miura, Yosuke Tajima, Yoshifumi Shimada, Jun Sakata & Toshifumi Wakai

  2. Department of Gastroenterological Surgery, Niigata Cancer Center Hospital, 2‑15‑3 Kawagishi‑cho, Chuo‑ku, Niigata, 951‑8566, Japan

    Masaki Aizawa & Hiroshi Yabusaki

  3. Department of Digestive Surgery, Niigata City General Hospital, 463‑7 Shumoku, Chuo‑ku, Niigata, 950‑1197, Japan

    Kazuaki Kobayashi & Shirou Kuwabara

  4. Department of Surgery, Nagaoka Chuo General Hospital, 2041 Kawasaki‑cho, Nagaoka, Niigata, 940‑0861, Japan

    Shigeto Makino & Yasuyuki Kawachi

Authors
  1. Yosuke Kano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroshi Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masaki Aizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yusuke Muneoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Usui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takaaki Hanyu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Yabusaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kazuaki Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shirou Kuwabara
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shigeto Makino
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yasuyuki Kawachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Kohei Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Yosuke Tajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yoshifumi Shimada
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Jun Sakata
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Toshifumi Wakai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroshi Ichikawa.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kano, Y., Ichikawa, H., Aizawa, M. et al. Macroscopic type is implicated in the prognostic impact of initial chemotherapy on peritoneal lavage cytology-positive gastric cancer with no other noncurative factors. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02496-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10147-024-02496-1

Keywords

Search

Navigation