Annals of Surgical Oncology

, Volume 24, Issue 4, pp 983–989 | Cite as

Prognostic Significance of Basing Treatment Strategy on the Results of Photodynamic Diagnosis in Advanced Gastric Cancer

  • Yuki Ushimaru
  • Yoshiyuki Fujiwara
  • Kentaro Kishi
  • Keijiro Sugimura
  • Takeshi Omori
  • Jeong-Ho Moon
  • Yoshitomo Yanagimoto
  • Masayuki Ohue
  • Masayoshi Yasui
  • Hidenori Takahashi
  • Shogo Kobayashi
  • Hirofumi Akita
  • Norikatsu Miyoshi
  • Akira Tomokuni
  • Masato Sakon
  • Masahiko Yano
Gastrointestinal Oncology

Abstract

Background

We have previously reported that use of a staging laparoscopy (SL) combined with photodynamic diagnosis using 5-aminolevulinic acid (ALA-SL) improves sensitivity in detecting peritoneal dissemination in gastric cancer (GC). The purpose of this study was to examine the clinical significance of basing treatment strategies on the results of ALA-SL in patients with advanced GC.

Patients and Methods

ALA-SL was performed on 113 patients with advanced GC prior to determination of their first course of treatment. According to the results of ALA-SL, patients were divided into four groups, including those classified as P0 (45%), ALA-P (12%), P1 plus P2 (23%), and P3 (20%). Patients with peritoneal metastases were subjected to chemotherapy. In addition, drug responders also received a gastrectomy. Treatment outcomes and patient characteristics stratified upon the results of ALA-SL were then analyzed.

Results

The 3-year survival rates for patients in the P0, ALA-P, P1-2, and P3 groups were 73, 72, 49, and 6%, respectively. The survival estimates of patients classified as ALA-P via ALA-SL were very similar to those of P0 patients and were significantly better than those of P1-2 and P3 patients. Moreover, the false negative rate for ALA-SL-mediated detection of peritoneal metastasis at exploration was minimal (1/40, 2.5%), possibly due to the use of ALA.

Conclusions

ALA-SL may enhance the accuracy of diagnosis and contribute to therapeutic advantages in advanced GC. It should be introduced for advanced GC patients, especially females, as well as for individuals with high-stage tumors and/or tumors with diffuse-type histology.

Keywords

Gastric Cancer Gastric Cancer Patient Advanced Gastric Cancer Peritoneal Metastasis Peritoneal Dissemination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Yuki Ushimaru
    • 1
  • Yoshiyuki Fujiwara
    • 1
  • Kentaro Kishi
    • 1
  • Keijiro Sugimura
    • 1
  • Takeshi Omori
    • 1
  • Jeong-Ho Moon
    • 1
  • Yoshitomo Yanagimoto
    • 1
  • Masayuki Ohue
    • 1
  • Masayoshi Yasui
    • 1
  • Hidenori Takahashi
    • 1
  • Shogo Kobayashi
    • 1
  • Hirofumi Akita
    • 1
  • Norikatsu Miyoshi
    • 1
  • Akira Tomokuni
    • 1
  • Masato Sakon
    • 1
  • Masahiko Yano
    • 1
  1. 1.Department of SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseaseOsakaJapan

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