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• W12294204 abstract "4156 Background: Free peritoneal tumor cells (FPTCs) are an independent prognostic factor in patients undergoing curative resection for gastric carcinoma. Whether neoadjuvant chemotherapy (NAC) can eliminate FPTCs in the peritoneal lavage remains unclear. The aim of the study was to determine the effect of NAC on FPTCs. Methods: From 1994-2000, a total of 61 patients with resectable gastric cancer were reviewed. Peritoneal cytology was performed before NAC and at tumor resection. A minimum of six weeks of NAC, consisting of cisplatin, folinic acid and fluorouracil was administered. FPTCs were detected immunhistochemically using Ber-EP4 antibody. Median follow-up was 7.3 years. Results: FPTCs could be detected in 19 (31%) patients before NAC. Positive cytology changed to be negative in 7 patients after NAC. Those patients showed a trend towards an improved median survival (36 months) and a longer 2-year survival (71%) compared to FPTC positive patients at staging and after chemotherapy (n = 12), with a median survival of 9.2 months and a 2- year survival rate of 25%. Median survival of all patients was 29 months. Patients with negative cytology after NAC (n = 39) survived significantly longer survival (37.9 months) compared to patients with positive cytology (n = 22) (13.3 months; p < 0.001). The presence of FPTCs at resection was associated with advanced ypT, ypN- and R-category, but not with clinical or histopathological response to NAC. Multivariate analysis identified ypN category, clinical response and the evidence of FPTCs as independent prognostic factors. All patients underwent gastrectomy, which resulted in 46 R0 (78%), and 15 R1/2 resections. In R0 resected patients (n = 46), multivariate analysis elucidated that both, ypN and clinical response were independent prognostic factors, but FPTCs before or after therapy were not. Conclusions: NAC for patients with positive cytology could lead into FPTC negativity in a subset of patients and to improve their prognosis. The detection of FPTCs at any time is associated with poor prognosis and could be used for risk-group stratification. No significant financial relationships to disclose." @default.
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• W12294204 date "2010-05-20" @default.
• W12294204 modified "2023-09-25" @default.
• W12294204 title "Prognostic significance of free peritoneal tumor cells in the peritoneal cavity before and after neoadjuvant chemotherapy in patients with gastric cancer undergoing a potentially curative resection." @default.
• W12294204 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.4156" @default.
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