This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Free peritoneal tumour cells are an independent prognostic factor in curatively resected stage IB gastric carcinoma. BJS 2006; 93: 325-331.
Published: 23rd February 2006
Authors: R. Rosenberg, H. Nekarda, P. Bauer, U. Schenck, H. Hoefler, J. R. Siewert et al.
Background
Several studies have shown that the cytological detection of free peritoneal tumour cells (FPTCs) in patients with gastric cancer indicates the presence of metastatic disease. The immunocytochemical detection of FPTCs, especially in early‐stage tumours, has not been examined comprehensively.
Results
FPTCs were detected in the lavage fluid of 74 patients (21·4 per cent) and correlated with increasing pathological tumour depth (pT) and lymph node (pN) status (P < 0·001). The 5‐year overall survival of patients with FPTCs was significantly worse than that of patients without FPTCs (35 versus 71·9 per cent; P < 0·001). FPTCs were present in 14 (8·5 per cent) of 164 patients with stage IA or IB tumours. Although the detection of FPTCs had no prognostic significance for stage IA tumours, the presence of FPTCs in those with stage IB tumours was associated with a worse prognosis (P < 0·001). Multivariate analysis identified the presence of FPTCs as an independent prognostic factor in the whole cohort and in the stage IB subgroup.
Conclusion
Detection of FPTCs is associated with poor prognosis even in patients with early‐stage gastric cancer and should be used for risk‐group stratification. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Full text