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Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study

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Abstract

Purpose

The peritoneum is the common recurrence site of gastric cancer (GC) presenting with worse survival. Although some predictive clinicopathological factors have been identified, there is no comprehensive assessment of peritoneal recurrence risk prediction for patients treated with adjuvant chemotherapy (CR) or chemoradiotherapy (CRT) after surgery. We aimed to predict peritoneal recurrence and develop a new scoring model in GC.

Methods

This retrospective study included 274 GC patients who presented with recurrence after curative gastrectomy followed by adjuvant chemotherapy (CT) or chemoradiotherapy (CRT). Risk factors for peritoneal recurrence were analyzed using the following parameters: age, gender, tumor location and characteristics, and differences between treatment modalities. All parameters were assessed by binary logistic regression analysis to compare the patients with and without peritoneal recurrence. Then, a new risk scoring model was developed.

Results

Peritoneal recurrence was observed in 115 (44.1%) patients. Peritoneal recurrence was higher in female gender (odds ratio (OR), 1.93; 1.07–3.49, P = 0.030, 1 point), T4a-b stage (OR, 2.47; 1.14–5.36, P = 0.022, 1 point), poor/undifferentiated (OR, 2.04; 1.31–4.06, P = 0.004, 1 point), and signet cell carcinoma (OR, 2.04; 1.04–4.02, P = 0.038, 1 point) after adjusted for resection and dissection types. The risk scoring model was developed using the related parameters: Peritoneal recurrence rates were 24.6%, 42.6%, and 71.4% for group 1 (0 point), group 2 (1–2 points), and group 3 (3–4 points), respectively.

Conclusion

Female gender, T4 tumor stage, undifferentiated histopathology, and signet cell type had a tendency to peritoneal recurrence after adjusted for treatment modalities. Patients with 3 or 4 risk factors had an 8.8-fold increased risk for the development of peritoneal recurrence.

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Authors and Affiliations

  1. School of Medicine, Department of Medical Oncology, Gaziantep University, TR-27310, Gaziantep, Turkey

    Tulay Kus

  2. School of Medicine, Department of Medical Oncology, Baskent University, Adana, Turkey

    Fatih Kose

  3. School of Medicine, Department of Medical Oncology, Kahramanmaras Sütçü İmam University, Kahramanmaraş, Turkey

    Gokmen Aktas

  4. Ankara Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey

    Ulku Yalcintas Arslan

  5. Department of Medical Oncology, Medical Park Tarsus Hospital, Tarsus, Turkey

    Ali Murat Sedef

  6. School of Medicine, Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey

    Havva Yesil Cinkir

  7. Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Merve Dirikoc

  8. School of Medicine, Department of Internal Medicine, Kahramanmaras Sütçü İmam University, Kahramanmaraş, Turkey

    Gulsum Akkus

  9. Faculty of Medicine, Department of Medical Oncology, Yıldırım Beyazıt University, Ankara, Turkey

    Nuriye Yildirim Ozdemir

Authors
  1. Tulay Kus
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  2. Fatih Kose
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Correspondence to Tulay Kus.

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This study was approved by the Institutional Ethics Committee and conducted in compliance with the ethical principles according to the Declaration of Helsinki

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Kus, T., Kose, F., Aktas, G. et al. Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study. J Gastrointest Canc 52, 634–642 (2021). https://doi.org/10.1007/s12029-020-00419-7

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  • DOI: https://doi.org/10.1007/s12029-020-00419-7

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