Surgery Today

, Volume 49, Issue 1, pp 56–64 | Cite as

Prognostic factors for cytology-positive gastric cancer

  • Shunji Endo
  • Masakazu Ikenaga
  • Katsuya Ohta
  • Masami Ueda
  • Yujiro Tsuda
  • Ryo Kato
  • Hiroaki Itakura
  • Jin Matsuyama
  • Kazuhiro Nishikawa
  • Terumasa YamadaEmail author
Original Article



Positive peritoneal lavage cytology for gastric carcinoma cells (CY1) is considered distant metastasis and is classified as Stage IV. However, patients with CY1 comprise a heterogeneous population, and their prognosis varies greatly. The prognostic factors for gastric cancer patients with CY1 were retrospectively reviewed.


The participants were 80 gastric cancer patients with CY1 in our institution encountered between 2005 and 2017. Prognostic factors were analyzed using univariate and multivariate analyses.


The operative procedure was distal gastrectomy for 30 patients, total gastrectomy for 27 patients, staging laparoscopy for 10 patients, gastrojejunostomy for 8 patients, and probe laparotomy for 5 patients. Other distant metastases were recognized in 36 patients. A multivariate analysis revealed that other distant metastases were the strongest independent risk factor for the overall survival (p < 0.0001). When the cohort was limited to CY1 patients without other distant metastases, cN2–3 (p = 0.01), the prognostic nutritional index (PNI) < 40 (p = 0.02) and Type 4 (p = 0.03) were independent risk factors according to a multivariate analysis. The survivals of patients with cN2–3 or PNI < 40 after gastrectomy were equivalent to those with other distant metastases, as assessed by log-rank analyses.


The prognoses of CY1 gastric cancer patients with cN2–3 or PNI < 40 were poor, even after gastrectomy.


Stomach neoplasms Abdominal lavage cytology Lymph node metastasis 


Compliance with ethical standards

Conflict of interest

All authors have no conflicts of interest.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Shunji Endo
    • 1
  • Masakazu Ikenaga
    • 1
  • Katsuya Ohta
    • 1
  • Masami Ueda
    • 1
  • Yujiro Tsuda
    • 1
  • Ryo Kato
    • 1
  • Hiroaki Itakura
    • 1
  • Jin Matsuyama
    • 2
  • Kazuhiro Nishikawa
    • 3
  • Terumasa Yamada
    • 1
    Email author
  1. 1.Department of Gastroenterological SurgeryHigashiosaka City Medical CenterHigashiosakaJapan
  2. 2.Department of SurgeryYao Municipal HospitalOsakaJapan
  3. 3.Department of SurgeryNational Hospital Organization Osaka National HospitalOsakaJapan

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