Application of molecular diagnosis for detection of peritoneal micrometastasis and evaluation of preoperative chemotherapy in advanced gastric carcinoma

In advanced gastric cancer, peritoneal recurrence is the main cause of death after curative surgical resection. The aim of this report was to describe a novel approach for quantitative genetic diagnosis using peritoneal lavage for the identification of patients at high risk for peritoneal recurrence...

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Bibliographic Details
Published in:Annals of surgical oncology 2004-01, Vol.11 (1), p.14-20
Main Authors: Mori, Takuji, Fujiwara, Yoshiyuki, Sugita, Yurika, Azama, Takashi, Ishii, Takaaki, Taniguchi, Kazuhiro, Yamazaki, Keiji, Takiguchi, Shuji, Yasuda, Takushi, Yano, Masahiko, Monden, Morito
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - pathology
Animals
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoembryonic Antigen - analysis
Cisplatin - therapeutic use
Disease Models, Animal
Female
Humans
Infusions, Intralesional
Laparoscopy
Male
Mice
Mice, Inbred BALB C
Mice, Nude
Middle Aged
Mitomycin - therapeutic use
Neoplasm Recurrence, Local
Peritoneal Neoplasms - secondary
Pilot Projects
Prognosis
Reverse Transcriptase Polymerase Chain Reaction
Stomach Neoplasms - drug therapy
Stomach Neoplasms - pathology
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Summary:In advanced gastric cancer, peritoneal recurrence is the main cause of death after curative surgical resection. The aim of this report was to describe a novel approach for quantitative genetic diagnosis using peritoneal lavage for the identification of patients at high risk for peritoneal recurrence and for evaluation of the clinical response to intraperitoneal chemotherapy in advanced gastric cancer. Nineteen patients with advanced gastric cancer who underwent staging laparoscopy and intraperitoneal chemotherapy before surgical resection or systemic chemotherapy between June 1999 and September 2001 were enrolled in this study. All peritoneal lavage specimens, collected at both staging laparoscopy and gastrectomy, were subjected to real-time quantitative genetic diagnosis. The reverse transcriptase polymerase chain reaction (RT-PCR) values decreased in 8 cases, stabilized as negative in 5, and increased in 6 during therapy. Patients whose RT-PCR values diminished and were ultimately negative survived except for one, and all but one patient whose values increased during treatment died of recurrence. Quantitative evaluation of genetic changes can provide accurate, useful information on the effects of preoperative intra-abdominal chemotherapy and overall prognosis for patients with advanced gastric cancer.
ISSN:1068-9265
1534-4681
DOI:10.1007/bf02524340