Microscopic peritoneal carcinomatosis in gastric cancer: Prevalence, prognosis and predictive factors

Pasqual,Enrico  Maria; Bertozzi,Serena; Londero,Ambrogio  P.; Brandolin,Denise; Mariuzzi,Laura; De Pellegrin,Alessandro; Bacchetti,Stefano; Zoratti,Loris; Petri,Roberto; Della Bianca,Carlo; Snidero,Daniele; Terrosu,Giovanni; Uzzau,Alessandro; Risaliti,Andrea; Di Loreto,Carla; Pizzolitto,Stefano; Zilli,Maurizio; de Manzoni,Giovanni

doi:10.3892/ol.2017.7442

Microscopic peritoneal carcinomatosis in gastric cancer: Prevalence, prognosis and predictive factors

Authors:
- Enrico Maria Pasqual
- Serena Bertozzi
- Ambrogio P. Londero
- Denise Brandolin
- Laura Mariuzzi
- Alessandro De Pellegrin
- Stefano Bacchetti
- Loris Zoratti
- Roberto Petri
- Carlo Della Bianca
- Daniele Snidero
- Giovanni Terrosu
- Alessandro Uzzau
- Andrea Risaliti
- Carla Di Loreto
- Stefano Pizzolitto
- Maurizio Zilli
- Giovanni de Manzoni
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Affiliations: Department of Medical Area, University of Udine, Santa Maria della Misericordia University Hospital Udine, I‑33100 Udine, Italy, Department of Obstetrics and Gynaecology, Monfalcone Hospital, I‑34074 Monfalcone, Italy, Department of Pathology, Santa Maria della Misericordia University Hospital Udine, I‑33100 Udine, Italy, Department of Gastroenterology, Santa Maria della Misericordia University Hospital Udine, I‑33100 Udine, Italy, Department of Surgery, Santa Maria della Misericordia University Hospital Udine, I‑33100 Udine, Italy, Department of Surgery, Tolmezzo Hospital, I‑33028 Tolmezzo, Italy, Department of Surgery, San Daniele Hospital, I‑33038 San Daniele, Italy, Department of Upper Gastrointestinal Surgery, The Civil Hospital of Verona University, I‑37126 Verona, Italy
Published online on: November 17, 2017 https://doi.org/10.3892/ol.2017.7442
Pages: 710-716
Copyright: © Pasqual et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Peritoneal carcinomatosis (PC) is typically identified in advanced stage gastric cancer and is frequently considered to be an incurable disease. Along with macroscopic PC, microscopic PC may be diagnosed through pathological examination of tissue specimens and is not detectable during surgical intervention. The present study aimed to analyse the prevalence, prognostic value and predictive factors for microscopic PC. In the present retrospective study, data from patients with epithelial gastric cancer that were treated with curative intent surgery were examined. Patients with macroscopic PC were excluded. Additionally, the study population was divided into two groups based on the presence or absence of microscopic PC. The prevalence of microscopic PC was 5.5%. Microscopic PC exhibited a significant negative effect on overall survival. In addition, multivariate analyses revealed that the significant predictive factors for the presence of microscopic PC were adenocarcinoma of a diffuse type, lymphatic and vascular invasion, cancer location at the site of previous gastric surgery and a tumour extent >T2. In particular, the presence of lymphatic and vascular invasion was the most significant predictive factor. These results indicate that ≥5.5% of patients with gastric cancer who undergo surgery with a curative intent may benefit from more aggressive loco‑regional treatment against microscopic PC at the time of surgery.

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