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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Department of Surgery, Shinsenri Hospital, Osaka, Japan

    Keiji Yamazaki MD, PhD

  2. Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, 2-2 E2, Yamadaoka, 565-0871, Suita-City, Osaka, Japan

    Takuji Mori MD, Yoshiyuki Fujiwara MD, PhD, Yurika Sugita BA, Takashi Azama MD, Takaaki Ishii MD, Kazuhiro Taniguchi MD, Shuji Takiguchi MD, Takushi Yasuda MD, PhD, Masahiko Yano MD, PhD & Morito Monden MD, PhD

Authors
  1. Takuji Mori MD
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  2. Yoshiyuki Fujiwara MD, PhD
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  3. Yurika Sugita BA
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  4. Takashi Azama MD
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  5. Takaaki Ishii MD
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  6. Kazuhiro Taniguchi MD
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  7. Keiji Yamazaki MD, PhD
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  8. Shuji Takiguchi MD
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  9. Takushi Yasuda MD, PhD
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  10. Masahiko Yano MD, PhD
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  11. Morito Monden MD, PhD
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Corresponding author

Correspondence to Yoshiyuki Fujiwara MD, PhD.

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Mori, T., Fujiwara, Y., Sugita, Y. et al. Application of molecular diagnosis for detection of peritoneal micrometastasis and evaluation of preoperative chemotherapy in advanced gastric carcinoma. Annals of Surgical Oncology 11, 14–20 (2004). https://doi.org/10.1007/BF02524340

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  • DOI: https://doi.org/10.1007/BF02524340

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