エンドウ　シュンジ   Shunji Endo   遠藤　俊治    所属   川崎医科大学  医学部 臨床医学　消化器外科学    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prognostic factors for cytology-positive gastric cancer.
掲載誌名	正式名：Surgery today 略　 称：Surg Today ISSNコード：14362813/09411291
掲載区分	国内
巻・号・頁	49(1),pp.56-64
著者・共著者	Endo Shunji, Ikenaga Masakazu, Ohta Katsuya, Ueda Masami, Tsuda Yujiro, Kato Ryo, Itakura Hiroaki, Matsuyama Jin, Nishikawa Kazuhiro, Yamada Terumasa
担当区分	筆頭著者
発行年月	2019/01
概要	PURPOSE:Positive peritoneal lavage cytology for gastric carcinoma cells (CY1) is considered distant metastasis and is classified as Stage IV. However, patients with CY1 comprise a heterogeneous population, and their prognosis varies greatly. The prognostic factors for gastric cancer patients with CY1 were retrospectively reviewed.METHODS:The participants were 80 gastric cancer patients with CY1 in our institution encountered between 2005 and 2017. Prognostic factors were analyzed using univariate and multivariate analyses.RESULTS:The operative procedure was distal gastrectomy for 30 patients, total gastrectomy for 27 patients, staging laparoscopy for 10 patients, gastrojejunostomy for 8 patients, and probe laparotomy for 5 patients. Other distant metastases were recognized in 36 patients. A multivariate analysis revealed that other distant metastases were the strongest independent risk factor for the overall survival (p < 0.0001). When the cohort was limited to CY1 patients without other distant metastases, cN2-3 (p = 0.01), the prognostic nutritional index (PNI) < 40 (p = 0.02) and Type 4 (p = 0.03) were independent risk factors according to a multivariate analysis. The survivals of patients with cN2-3 or PNI < 40 after gastrectomy were equivalent to those with other distant metastases, as assessed by log-rank analyses.CONCLUSIONS:The prognoses of CY1 gastric cancer patients with cN2-3 or PNI < 40 were poor, even after gastrectomy.
DOI	10.1007/s00595-018-1704-1
PMID	30167924