Bausys A, Gricius Z, Aniukstyte L, Luksta M, Bickaite K, Bausys R, Strupas K. Current treatment strategies for patients with only peritoneal cytology positive stage IV gastric cancer. World J Clin Cases 2021; 9(32): 9711-9721 [PMID: 34877310 DOI: 10.12998/wjcc.v9.i32.9711]
Corresponding Author of This Article
Augustinas Bausys, MD, Surgeon, Department of Abdominal Surgery and Oncology, National Cancer Institute, Santariskiu str. 1, Vilnius 08406, Lithuania. augustinas.bausys@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2021; 9(32): 9711-9721 Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9711
Current treatment strategies for patients with only peritoneal cytology positive stage IV gastric cancer
Augustinas Bausys, Zilvinas Gricius, Laura Aniukstyte, Martynas Luksta, Klaudija Bickaite, Rimantas Bausys, Kestutis Strupas
Augustinas Bausys, Rimantas Bausys, Department of Abdominal Surgery and Oncology, National Cancer Institute, Vilnius 08406, Lithuania
Augustinas Bausys, Martynas Luksta, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
Zilvinas Gricius, Laura Aniukstyte, Klaudija Bickaite, Faculty of Medicine, Vilnius University, Vilnius 08406, Lithuania
Kestutis Strupas, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 03101, Lithuania
Author contributions: Bausys R and Strupas K conceptualized and designed the work; Bausys A, Gricius Z, Aniukstyte L, and Bickaite K performed the literature review and critical revision of the studies; Bausys A, Gricius Z, Bickaite K, and Aniukstyte L prepared the manuscript; Bausys R and Strupas K revised the manuscript; and all authors read and approved the final form of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Augustinas Bausys, MD, Surgeon, Department of Abdominal Surgery and Oncology, National Cancer Institute, Santariskiu str. 1, Vilnius 08406, Lithuania. augustinas.bausys@gmail.com
Received: June 20, 2021 Peer-review started: June 20, 2021 First decision: July 2, 2021 Revised: July 28, 2021 Accepted: September 15, 2021 Article in press: September 15, 2021 Published online: November 16, 2021
Abstract
Gastric cancer (GC) is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for it. Although a significant proportion of GC patients are found with distant metastases already at the initial diagnosis. Peritoneal dissemination is the most common site of metastases. Positive peritoneal cytology (Cy1) is associated with poor long-term outcomes; thus, these patients are considered as stage IV even if macroscopic carcinomatosis is absent. Currently, there is no clear evidence for the most optimal treatment for this distinct subpopulation of the stage IV cohort. Available strategies vary from palliative chemotherapy to upfront gastrectomy. This comprehensive review summarized current evidence of different treatment strategies for Cy1 GC including roles of surgery, systemic and intraperitoneal chemotherapy.
Core Tip: Positive peritoneal cytology (Cy1) is associated with poor long-term outcomes; thus, these patients are considered as stage IV even if macroscopic carcinomatosis is absent. The evidence for the most efficient treatment of these patients is conflicting. We herein review current knowledge and the outcomes of different approaches for Cy1 gastric cancers.
