Prognostic factors for the development of peritoneal carcinosis in gastriccancer

Objective: Several adjuvant therapy concepts have been developed to improve the treatment of gastric cancer patients. Dealing with intraperitoneal che motherapy, it seems to be useful to determine suitable prognostic factors f or the occurrence of peritoneal carcinosis, as it is possible to select pat ients who may profit from this therapy. Methods: Between June 1975 and Dece mber 1999 resection of gastric cancer was performed in 575 patients. From 1 January 1986 clinical data were recorded prospectively, before that time, retrospectively. The complete data concerning preoperative diagnosis, opera tion, histology, postoperative course and survival time were documented in an Excel file for statistical analysis. Multivariate analysis was performed using the chi-squared logistic regression test. Results: Significant corre lation was found between the occurrence of peritoneal dissemination and tum our stage pT3, pN2, G3, cancer of the whole stomach and cancer at the anast omotic site after partial gastric resection. Lauren classification, signet- ring cell cancer, liver metastasis and tumour localisation in the distal or proximal stomach showed no significant correlation to peritoneal carcinosi s in the multivariate analysis. However, only one-third of patients with li ver metastasis had simultaneous peritoneal dissemination. Conclusion: The r esults show a clinical correlation of tumour localisation, infiltration of the serosa, lymph node metastasis and grading with peritoneal dissemination . The present data serve as a basis for further histochemical and molecular biological investigations e.g. of the expression of adhesion molecules to determine the risk of peritoneal. tumour dissemination after gastric cancer .