Prognostic value of peritoneal lavage cytology and chemotherapy during surgery for advanced gastric cancer

Background: The prognostic value of infra-operative peritoneal lavage cytol ogy and chemotherapy was evaluated retrospectively. Method: Lavage cytology was performed in 257 patients. Prognosis was invest igated in 85 of pT3 and pT4 patients with radical gastrectomy Intra-operati ve chemotherapy was selected according to the cytology and exploration of t he peritoneal cavity. For patients forecasted to have peritoneal recurrence , intraperitoneal injection of cisplatin was performed. Results: No free cancer cells (cy(-)) were found in pTis, pT1 and pT2. In p T3 and pT4, cy(-) were 82.8% of the cases without macroscopic metastasis (P (-)), and the presence of free cancer cells (cy(+)) were 89.3% of the cases with macroscopic metastasis (P(+)), Intraperitoneal injection was performe d in about 60% of P(-)/cy(+) and P(+) cases, Five-year survival rate of P(- )/cy(-) was 41.7% and that of P(-)/cy(+) was 33.3%. All of P(+) died within 3 years. Conclusion: Patients of P(-)/cy(+) probably had microscopic residual diseas e and might benefit from intraperitoneal chemotherapy.