Abstract | PURPOSE: Despite continuously improving therapies, gastric cancer still shows poor survival in locally advanced stages with local recurrence rates of up to 50% and peritoneal recurrence rates of 17% after curative surgery. We performed a systematic review with meta-analyses to clarify whether positive intraperitoneal cytology (IPC) indicates a high risk of disease recurrence and poor overall survival in gastric cancer. METHODS: Multiple databases were searched in December 2014 to identify studies on the prognostic significance of positive intraperitoneal cytology in gastric cancer, including: Medline, Biosis, Science Citation Index, Embase, CCMed and publisher databases. Hazard ratios (HR) and associated 95% confidence intervals (CI) were extracted from the identified studies. A meta-analysis was performed using a random-effects model on overall survival, disease-free survival and peritoneal recurrence free survival. RESULTS: A total of 64 studies with a cumulative sample size of 12,883 patients were included. Cytology, quantitative real time polymerase chain reaction (PCR) or both were performed in 35; 21 and 8 studies, respectively. Meta analyses revealed free intraperitoneal tumor cells ( FITC) to be associated with poor overall survival in univariate (HR 3.27; 95% CI 2.82 - 3.78]) and multivariate (HR 2.45; 95% CI 2.04 - 2.94) analysis and poor peritoneal recurrence free survival in univariate (4.15; 95% CI 3.10 - 5.57) and multivariate (3.09; 95% CI 2.02 - 4.71) analysis. Subgroup analysis showed this effect to be independent of the detection method, Western or Asian origin or the time of publication. CONCLUSIONS:
FITC oder positive peritoneal cytology is associated with poor survival and increased peritoneal recurrence in gastric cancer.
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Authors | Mathieu Pecqueux, Johannes Fritzmann, Mariam Adamu, Kristian Thorlund, Christoph Kahlert, Christoph Reißfelder, Jürgen Weitz, Nuh N Rahbari |
Journal | Oncotarget
(Oncotarget)
Vol. 6
Issue 34
Pg. 35564-78
(Nov 03 2015)
ISSN: 1949-2553 [Electronic] United States |
PMID | 26384352
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Topics |
- Animals
- Histological Techniques
(methods)
- Humans
- Peritoneum
(pathology)
- Prognosis
- Stomach Neoplasms
(diagnosis, mortality, surgery)
- Survival Analysis
- Treatment Outcome
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