Gastric cancer with positive peritoneal cytology: survival benefit after induction chemotherapy and conversion to negative peritoneal cytology

Abstract Background The optimal treatment in patients with gastric cancer and peritoneal disease remains controversial. Some guidelines indicate palliative only, while others consider surgical case of positive lavage cytology (CY+) or limited disease. Here, we analyzed the role cancer, prognostic relevance response to neoadjuvant therapy. Methods In this retrospective cohort analysis, adenocarcinoma stomach esophago-gastric junction from a single center operated between 2011 2019. According histology cytology, were classified into four risk groups: (A) no disease, (B) CY+ who converted negative (CY?) after chemotherapy, (C) without conversion (D) visible metastasis. Results Overall, n = 172 included. At initial presentation, 125 (73%) had about third ( 47, 27%) microscopic macroscopic Among them, 14 (8%) metastasis, 9 CY? 5 was observed. Median overall survival not reached initially resulting 3-year rates 65% 53%. contrast, median reduced 13 months (95% CI 8.7–16.7) 16 12–20.5) metastasis difference two groups p .364). rate significantly higher FLOT (5-fluorouracil plus leucovorin, oxaliplatin, docetaxel) compared ECF (epirubicin, cisplatin, 5-fluorouracil) 0.027). Conclusion Conversion chemotherapy is significant factor for better survival. Surgical well-selected should therefore be considered. However, recurrence frequent despite conversion, urging local control.