Tumor-positive peritoneal cytology in patients with gastric cancer is associated with poor outcome: A nationwide study

Karen Van Der Sluis*, Steven N. Taylor, Liudmila L. Kodach, Jolanda M. van Dieren, Ignace H.J.T. de Hingh, Bas P.L. Wijnhoven, Rob H.A. Verhoeven, Marieke A. Vollebergh, Johanna W. van Sandick

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: 

The clinical significance of tumor-positive peritoneal cytology (CYT+) in gastric cancer (GC) patients is unclear. This nationwide cohort study aimed to i) assess the frequency of cytological analysis at staging laparoscopy; ii) determine the prevalence of CYT+GC; and iii) compare overall survival (OS) in CYT+ patients versus those with (PM+) and those without (PM-) macroscopic peritoneal disease. 

Methods: 

All patients diagnosed with cT1–4, cN0–2 and M0 or synchronous PM GC between 2016–2021 were identified in the Netherlands Cancer Registry database and linked to the nationwide pathology database. 

Results: 

A total of 4397 patients was included, of which 40 % underwent cytological assessment following staging laparoscopy (863/1745). The prevalence of CYT+ was 8 %. A total of 69 patients had CYT+(1.6 %), 789 (17.9 %) had PM+ and 3539 (80.5 %) had PM- disease. Hazard ratio for OS in CYT+ versus PM+ was 0.86 (95 %CI 0.64–1.17, p-value=0.338), and in PM- versus PM+0.43 (95 %CI 0.38–0.49, p-value<0.001). No survival difference was found between systemic chemotherapy versus surgical resection in CYT+ patients. 

Discussion:

In this nationwide study, OS for gastric cancer patients with CYT+ was equally unfavorable as for those with PM+ and significantly worse as compared to those with PM-. The optimal treatment strategy has yet to be established.

Original languageEnglish
Article number113541
JournalEuropean Journal of Cancer
Volume199
DOIs
Publication statusPublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 Elsevier Ltd

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