Comprehensive treatment for the peritoneal metastasis from gastric cancer

Table 1 Peritoneal wash cytology before and after bidirectional intraperitoneal and systemic induction chemotherapy

Cytology	Cytology after BIPSC
Before BIPSC	Negative	Positive	Total
Negative	15	0	15
Positive	26 (79%)	7	33
	41	7	48

Peritoneal wash cytology was done through a peritoneal port system after intraperitoneal administration of 500 mL of saline. BIPSC: Bidirectional intraperitoneal and systemic induction chemotherapy.

Table 2 Peritoneal wash cytology before and after neoadjuvant intraperitoneal/systemic chemotherapy

Cytology	Cytology after NIPS
Before NIPS	Negative	Positive	Total
Negative	47	1	48
Positive	69 (70%)	30	99
	116	31	147

NIPS: Neoadjuvant intraperitoneal/systemic chemotherapy.

Table 3 Histoloogic effects of primary tumor and peritoneal carcinomatosis in 41 patients after bidirectional intraperitoneal and systemic induction chemotherapy

	EF-0	EF-1	EF-2	EF-3	Total
Primary tumors	3 (12%)	15 (58%)	7 (27%)	1 (4%)	26 (100%)
Peritoneal metastasis	7 (17%)	18 (44%)	7 (17%)	9 (22%)	41 (100%)

EF-0: No histological change or histologic change is found in less than one-third of the tumor tissue; EF-1: Degeneration of cancer cells is detected in the tumor tissue ranging from one-third to less than two thirds; EF-2: The degeneration of cancer cells is found in more than two-thirds of the tumor tissue; EF-3: Complete disappearance of cancer cells.

Table 4 Histoloogic effects of primary tumor and peritoneal carcinomatosis in 147 patients with PC treated with neoadjuvant intraperitoneal/systemic chemotherapy

	EF-0	EF-1	EF-2	EF-3	Total
Primary tumors	13 (18%)	38 (54%)	20 (28%)	0	71 (100%)
Peritoneal metastasis	59 (40%)	35 (24%)	14 (10%)	39 (25%)	147 (100%)

Table 5 Side effects during bidirectional intraperitoneal and systemic induction chemotherapy

Grade 0	Grade 1-2	Grade 3	Grade 4	Grade 5	Total
44 (76%)	8 (14%)	4 (7%)	2 (3%)	0 (0%)	58

Table 6 Multivariate analysis of 304 patients with peritoneal metastasis treated with a comprehensive treatmnent

Prognostic factors	χ2	P value	HR	95%CI
Sex male vs female	0.263	0.60752	0.9218	0.676	1.257
CC score: complete vs incomplete	4.03	0.04468	1.504	1.01	2.24
Nodal involvement: N0-1 vs N2-3	0.445	0.50454	1.1338	0.784	1.639
Neoadjuvant chemo.: negative vs positive	2.517	0.11259	1.3445	0.933	1.938
PCI: ≤ 6 vs≥ 7	8.809	0.00299	1.7863	1.218	2.621
HIPEC: Not done vs done	8.218	0.00414	0.6322	0.462	0.865
Histilogicl effects: EF 0-1 vs EF 2-3	12.305	0.00045	0.469	0.307	0.716
Cytology: Negative vs positive	8.2163	0.00415	1.8458	1.213	2.806

PCI: Peritoneal carcinomatosis index; HIPEC: Hyperthermic intraoperative intraperitoneal chemotherapy.