Survival Outcomes of Gastric Adenocarcinoma Patients with Peritoneal Carcinomatosis: A Retrospective Study

Abstract

Background: Gastric adenocarcinoma is a leading cause of cancer-related mortality worldwide, with peritoneal carcinomatosis representing a critical factor for poor prognosis. The survival of patients with gastric cancer and peritoneal metastasis remains limited, prompting a need for comprehensive studies that explore factors influencing outcomes and potential therapeutic strategies. Objective: To investigate the survival rates and associated prognostic factors of peritoneal carcinomatosis in patients with gastric adenocarcinoma, focusing on the impact of various clinical and pathological characteristics. Materials and Methods: The present study was conducted at Ramathibodi Hospital, Mahidol University, Bangkok, between January 2012 and January 2023. This single-center retrospective study included 106 patients diagnosed with gastric adenocarcinoma and peritoneal metastasis. Data on demographics, clinical presentation, treatment modalities, and outcomes were analyzed. Survival outcomes were assessed using Kaplan-Meier estimated, and factors associated with peritoneal recurrence and survival were identified through logistic regression analysis. Results: The clinical characteristics of 106 patients with gastric cancer and peritoneal metastasis were evaluated. Factors associated with peritoneal recurrence included N stage, lymph node involvement, and the presence of signet ring cells. Patients with positive lymph nodes during the operation were statistically significantly found to be in stage IV group and have peritoneal carcinomatosis recurrence (p=0.007). Furthermore, N stage was associated with recurrence (p=0.027). Survival in patients with gastric adenocarcinoma with peritoneal carcinomatosis who had positive cytology, but negative peritoneal metastasis had median survival time of 5.41 months. Patients with positive malignancy in cytology exam, but positive peritoneal metastasis had median survival time of 5.18 months. Conclusion: Peritoneal metastasis in gastric adenocarcinoma patients is associated with a dismal prognosis. The findings showed the critical need for early detection and the exploration of novel therapeutic strategies. Further research is essential to validate these results and optimize treatment protocols.