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 26 May 2018

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News

Free peritoneal tumor cells predict gastric cancer outcome

Detection of free peritoneal tumor cells is associated with poor prognosis even in patients with early-stage gastric cancer, and should be used for risk-group stratification, reports this month's British Journal of Surgery.

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Several studies have shown that the cytological detection of free peritoneal tumor cells in gastric cancer indicates the presence of metastatic disease.

The immunocytochemical detection of free peritoneal tumor cells, especially in early-stage tumors, has not been examined comprehensively.

Dr Rosenberg and colleagues performed peritoneal lavage in 351 patients before curative resection of a gastric carcinoma.

The team obtained an adequate sample from 346 patients between 1987 and 2001.

Free peritoneal tumor cells were detected immunocytochemically using Ber-EP4 antibody.

The median follow-up time was 70 months.

The research team detected free peritoneal tumor cells in the lavage fluid of 21% of patients.

The free peritoneal tumor cells correlated with increasing pathological tumor depth and lymph node status.

5-year survival of patients with free peritoneal tumor cells was 35% vs 72% in patients without
British Journal of Surgery

The 5-year overall survival of patients with free peritoneal tumor cells was significantly worse at 35% vs 72% in patients without.

The team noted that free peritoneal tumor cells were present in 14 of 164 patients with stage IA or IB tumors.

The detection of free peritoneal tumor cells had no prognostic significance for stage IA tumours.

However, the team observed that the presence of free peritoneal tumor cells in those with stage IB tumours was associated with a worse prognosis.

Multivariate analysis identified the presence of free peritoneal tumor cells as an independent prognostic factor in the whole cohort, and in the stage IB subgroup.

Dr Rosenberg's team concludes, “Detection of free peritoneal tumor cells is associated with poor prognosis even in patients with early-stage gastric cancer and should be used for risk-group stratification.”

Br J Surg 2006: 93(3): 325-31
02 March 2006

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