Long-term follow up of patients who were positive for peritoneal lavage cytology: final report from the CCOG0301 study.

Background: In gastric cancer patients who have positive results for peritoneal lavage cytology the disease is defined as CY1, and classified as stage IV, and this population has generally suffered a dismal outcome. For this population, we had conducted a phase II trial, with the 2-year survival rate as the primary endpoint, to test the strategy of D2 dissection followed by chemotherapy with single-agent S-1 (1 M tegafur-0.4 M gimestat-1 M otastat potassium). Forty-eight patients were enrolled, of whom 47 were found to have been eligible for analysis. The 2-year survival rate of 46 % exceeded our expectations.
Methods: Further follow up was conducted to confirm whether radical surgery could be recommended for the CY1 population.
Results: The 5-year overall and relapse-free survival rates were 26 and 21 %, respectively.
Conclusions: Gastrectomy with curative intent could be considered for patients with CY1 disease provided they are scheduled to receive effective postoperative chemotherapy.